A Longitudinal Survey of Postgraduate Residency Hospital Type and Career Paths in Japan (1996–2016)

Abstract

Background: Postgraduate clinical training—a two-year residency program after graduation—became compulsory in Japan in 2004, prompting a shift in residency site preference for new graduates from university to non-university hospitals. Methods: Starting from the hypothesis that shortages of residents at university hospitals continue to be a problem in Japan, a longitudinal study was conducted based on secondary data collected from a biannual national physician survey. The career paths for physicians by residency hospital type were analyzed. The attributes of two physician cohorts were examined a decade after their registration, in 1996 and 2004 respectively, to understand how having carried out their residency at university or non-university hospitals affected their careers.Results: Around 40% of residents were training at university hospitals in their first year of registration at the time of the 2004 reform. In contrast, physicians working at university hospitals in their third year of registration rose to around 40%. Physicians who had not worked at university hospitals during their first ten years increased from 12% in 2004 to 18% in 2014.Conclusions: Since the introduction of mandatory postgraduate clinical training, residents’ career paths have changed based on the type of hospital where they attended residency. Resident shortages at university hospitals remain a challenge in Japan.