Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan

Koike, Soichi; Ide, Hiroo; Yasunaga, Hideo; Kodama, Tomoko; Matsumoto, Shimpei; Imamura, Tomoaki

doi:10.1111/j.1365-2923.2009.03582.x

Cited by 21 publications

(22 citation statements)

References 22 publications

(33 reference statements)

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“…A Japanese governmental report revealed that obstetrics & gynecology, pediatrics, and anesthesiology have suffered a more severe shortage than other specialties [2]. Moreover, the decreasing tendency of doctors to choose internal medicine and surgery has accelerated [3]. …”

Section: Introductionmentioning

confidence: 99%

Gender difference in preference of specialty as a career choice among Japanese medical students

et al. 2016

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BackgroundIn Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students.MethodsA total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18–34) years and 227 men aged 22 ± 4 (range, 18–44) years. Binary Logistic regression analysis was performed using specialty preferences as the criterion variable and the factors in brackets as six motivational variables (e.g., Factor 1: educational experience; Factor 2: job security; Factor 3: advice from others; Factor 4: work-life balance; Factor 5: technical and research specialty; and Factor 6: personal reasons).ResultsWomen significantly preferred pediatrics, obstetrics & gynecology, and psychology than the men. Men significantly preferred surgery and orthopedics than the women. For both genders, a high odds ratio (OR) of “technical & research specialty” and a low OR for “personal reasons” were associated with preference for surgery. “Technical & research specialty” was positively associated with preference for special internal medicine and negatively for pediatrics. “Work-life balance” was positively associated with preference for psychology and negatively for emergency medicine. Among the women only, “technical & research specialty” was negatively associated with preference for general medicine/family medicine and obstetrics & gynecology, and “job security” was positively associated for general medicine/family medicine and negatively for psychology. Among men only, “educational experience” and “personal reasons” were positively, and “job security” was negatively associated with preference for pediatrics. For both genders, “work-life balance” was positively associated with preference for controllable lifestyle specialties.ConclusionWe must acknowledge that Japanese medical students have dichotomized some motivations for their specialty preference based on gender. Systematic improvements in the working environment are necessary to solve these issues.

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Section: Introductionmentioning

confidence: 99%

Gender difference in preference of specialty as a career choice among Japanese medical students

et al. 2016

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“…This implies that studies in a varied healthcare system would add different insight into specialty preference. Although literature from countries other than U.S.A. and U.K. are available, those studies have tended to focus on a few specific specialties [53-55], gender difference [56], graduates who have already chosen the specialty [57], or conducted with limited participants at a single medical school [55]. Therefore, large scale studies on both students and graduates with a focus on diverse specialties are needed to obtain findings more applicable to countries in which the health system is more equitable and most students enter medical school as undergraduates (directly from secondary school).…”

Section: Introductionmentioning

confidence: 99%

“…In Japan, after 6 years of medical school, there is a two year foundation programme consisting of required and elective clinical rotations [57], during which the final decision of career choice is made. Due to the absence of regulatory mechanisms to generate balanced distribution of workforce, it allows virtually any graduate to obtain the type of specialty training desired regardless of their performance during the foundation years.…”

Section: Introductionmentioning

confidence: 99%

Characteristic profiles among students and junior doctors with specific career preferences

et al. 2013

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BackgroundFactors influencing specialty choice have been studied in an attempt to find incentives to enhance the workforce in certain specialties. The notion of “controllable lifestyle (CL) specialties,” defined by work hours and income, is gaining in popularity. As a result, many reports advocate providing a ‘lifestyle-friendly’ work environment to attract medical graduates. However, little has been documented about the priority in choosing specialties across the diverse career opportunities.This nationwide study was conducted in Japan with the aim of identifying factors that influence specialty choice. It looked for characteristic profiles among senior students and junior doctors who were choosing between different specialties.MethodsWe conducted a survey of 4th and 6th (final)-year medical students and foundation year doctors, using a questionnaire enquiring about their specialty preference and to what extent their decision was influenced by a set of given criteria. The results were subjected to a factor analysis. After identifying factors, we analysed a subset of responses from 6th year students and junior doctors who identified a single specialty as their future career, to calculate a z-score (standard score) of each factor and then we plotted the scores on a cobweb chart to visualise characteristic profiles.ResultsFactor analysis yielded 5 factors that influence career preference. Fifteen specialties were sorted into 4 groups based on the factor with the highest z-score: “fulfilling life with job security” (radiology, ophthalmology, anaesthesiology, dermatology and psychiatry), “bioscientific orientation” (internal medicine subspecialties, surgery, obstetrics and gynaecology, emergency medicine, urology, and neurosurgery), and “personal reasons” (paediatrics and orthopaedics). Two other factors were “advice from others” and “educational experience”. General medicine / family medicine and otolaryngology were categorized as “intermediate” group because of similar degree of influence from 5 factors.ConclusionWhat is valued in deciding a career varies between specialties. Emphasis on lifestyle issues, albeit important, might dissuade students and junior doctors who are more interested in bioscientific aspects of the specialty or have strong personal reasons to pursue the career choice. In order to secure balanced workforce across the specialties, enrolling students with varied background and beliefs should be considered in the student selection process.

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“…We obtained other variables from the 2010 survey. Since 2004, physicians in Japan have been required to undertake a 2-year postgraduate clinical training program [14, 15]. In this study, we use the term “resident” to signify a physician who was undergoing postgraduate clinical training.…”

Section: Methodsmentioning

confidence: 99%

Characteristics of Physician Outflow from Disaster Areas following the Great East Japan Earthquake

Kashima

Inoue

2017

PLoS ONE

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ObjectiveThe shortage of physicians after a major disaster is a crucial issue. We aimed to evaluate the characteristics of physicians who left affected areas following the accident at Fukushima Daiichi Nuclear Power Plant caused by the Great East Japan Earthquake on March 11, 2011.MethodsUsing data from a physician census conducted in 2010 (pre-disaster) and 2012 (post-disaster), we evaluated changes in the number of physicians in affected areas. We then calculated the odds ratios and 95% confidence intervals using a logistic regression model to evaluate the association between physician characteristics and outflow. We also conducted stratified analyses based on physician characteristics.ResultsThe number of physicians decreased in Fukushima Prefecture (–5.3%) and increased in Miyagi Prefecture (2.8%). The decrease in Fukushima and increase in Miyagi were evident even after taking the prefecture’s population change into account (change in physician to population ratios: –1.9% and 3.2%, respectively). Compared with physicians who lived in areas >100 km from the nuclear power plant, physicians living 20–50 km and 50–100 km were, respectively, 3.9 times (95% confidence interval, 2.6–5.7) and 2.6 times (95% confidence interval, 1.7–3.8) more likely to migrate to distant areas. In the stratified analysis, younger physicians and those earlier in their careers had higher odds ratios for outflow than other physicians (P for interaction = 0.02 and <0.01, respectively).ConclusionsThe risk of outflow was greater among younger and early-career physicians in areas around the power plant. Political support may be necessary to recruit and retain such physicians, who will be responsible for future community health in the disaster area.

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Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan

Cited by 21 publications

References 22 publications

Gender difference in preference of specialty as a career choice among Japanese medical students

Gender difference in preference of specialty as a career choice among Japanese medical students

Characteristic profiles among students and junior doctors with specific career preferences

Characteristics of Physician Outflow from Disaster Areas following the Great East Japan Earthquake

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