Results of physician licence examination and scholarship contract compliance by the graduates of regional quotas in Japanese medical schools: a nationwide cross-sectional survey

Takeuchi, Keisuke; Owaki, Tetsuhiro; Iguchi, Seitaro; Inoue, Kazuo; Kashima, Saori; Tazuma, Susumu; Maeda, Takahiro

doi:10.1136/bmjopen-2017-019418

Cited by 14 publications

(19 citation statements)

References 16 publications

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“…The results of medical facility choice are reported in columns (5) to (8). In this aspect, we found quite strong effects.…”

Section: Regression Resultsmentioning

confidence: 67%

“…In response to this issue, some countries have implemented policy packages including the reform of medical school admissions criteria and curriculum [4]. Japan also implemented a major curriculum reform in 2004 and has adopted targeted admissions policies since 2009 with the goal of promoting the participation of young physicians in primary care and alleviating the geographic maldistribution of primary care physicians [5,6]. Also, a new board certification system for physicians' clinical specialties was implemented in 2018, which officially acknowledged family medicine and general practice as a new discipline [7].…”

Section: Introductionmentioning

confidence: 99%

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How is increased selectivity of medical school admissions associated with physicians’ career choice? A Japanese experience

Takaku

2020

Hum Resour Health

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Background: During the long-lasting economic stagnation, the popularity of medical school has dramatically increased among pre-medical students in Japan. This is primarily due to the belief that medicine is generally a recession-proof career. As a result, pre-medical students today who want to enter medical school have to pass a more rigorous entrance examination than that in the 1980s. This paper explores the association between the selectivity of medical school admissions and graduates' later career choices. Methods: A unique continuous measure of the selectivity of medical school admissions from 1980 to 2017, which is defined as the deviation value of medical schools, was merged with cross-sectional data of 122 990 physicians aged 35 to 55 years. The association between the deviation value of medical schools and various measures of physicians' career choices was explored by logistic and ordinary least square regression models. Graduates from medical schools in which the deviation value was less than 55 were compared with those from more competitive medical schools, after controlling for fixed effects for the medical school attended by binary variables. Results: From 1980 to 2017, the average deviation value increased from 58.3 to 66.3, indicating a large increase in admission selectivity. Empirical results suggest that increasing selectivity of a medical school is associated with graduates having a higher probability of choosing a career in an acute hospital as well as having a lower probability of opening their own clinic and choosing a career in primary health care. Graduating from a highly competitive medical school (i.e., deviation value of more than 65) significantly increases the probability of working at typical acute hospitals such as so-called 7:1 hospitals (OR 1.665 2, 95%CI 1.444 0-1.920 4) and decreases the probability of working at primary care facilities (OR 0.602 6, 95%CI 0.441 2-0.823 0). It is also associated with graduates having a higher probability of becoming medical board certified (OR 1.294 6, 95%CI 1.108 8-1.511 4). Conclusion: Overall, this paper concludes that increased selectivity of medical school admissions predicts a higher quality of physicians in their own specialty, but at the same time, it is associated with a lower supply of physicians who go into primary care.

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“…The results of medical facility choice are reported in columns (5) to (8). In this aspect, we found quite strong effects.…”

Section: Regression Resultsmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

How is increased selectivity of medical school admissions associated with physicians’ career choice? A Japanese experience

Takaku

2020

Hum Resour Health

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“…Matsumoto et al 7 , evaluating the performance of students participating in the Japanese government's Quotas and Scholarship program, focused on public schools, also observed that their academic performance was superior to that of their peers.…”

Section: Discussionmentioning

confidence: 99%

The Academic Performance of Scholarship Students during Medical School

Moreira

Passeri

Velho

et al. 2019

Rev. bras. educ. med.

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The inclusion, adherence and success of low-income undergraduates are important goals in Brazilian higher education, as well as in other parts of the world, especially in busy and full-time courses such as medicine. This paper analyzes the performance of undergraduate medical students by comparing two groups: those who applied for and received a scholarship during the academic years (scholarship holders) and the others (without scholarship). We analyzed data from 417 medical students who graduated between 2010 and 2013, corresponding to four years of a retrospective cohort at a free public university in Brazil. Statistical analysis was performed using Fisher’s exact test, Student’s t test, Mann-Whitney test, and linear regression to compare the scores of these groups in the sixth and twelfth semesters (middle and final semesters) and in the admission exam for medical residency programs, consisting of: total score, multiple choice test for knowledge assessment, simulated structured clinical assessment, interview and written questions. The independent variable was to receive a scholarship, while the control variables were age, socioeconomic strata, extra gratuities for high school in public institution and self-declaration of race, score in the vestibular entry exam (general and in each area assessed) and parents’ level of education. A total of 243 students (58.2%) received a scholarship, most of them as a scientific initiation grant (217 or 89.3%), while 10.7% received social assistance, the average income per capita was about 16% lower among students who received a scholarship (p = 0.01) compared to those who did not. Scholarship recipients achieved better academic performance in the sixth (p<0.01) and in the twelfth (p<0.01) semester, but not in admission to medical residency programs. Good performance was independent of age, race, receipt of bonuses for admission to medical school, and educational background of their parents. Therefore, we conclude that receiving a scholarship at the undergraduate level was associated tobetter student performance during the undergraduate medical course. It is important to emphasize the importance of reinforcing similar programs, especially to help support students who are most vulnerable socioeconomically.

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“…The quota had spread from a few to 67 of all the 80 medical schools and the number of entrants is now 1504, accounting for 16% of all medical school students in Japan. Most of the quota entrants are funded by their home prefectures with the understanding that for several years after graduation they will practice in designated areas (mostly rural areas) of the home prefectures [ 29 , 30 ]. The first quota entrants have just started to be assigned to rural areas.…”

Section: Discussionmentioning

confidence: 99%

Aging of hospital physicians in rural Japan: A longitudinal study based on national census data

et al. 2018

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BackgroundThe disparity in the number of urban and rural physicians is a social problem in Japan. There may also be a disparity in the age of physicians. This study longitudinally examines both geographic and age distributions of physicians.MethodsIndividual data from the Survey of Physicians, Dentists and Pharmacists in 1994, 2004 and 2014 and municipality data from the National Population Census were used. The 2015 municipality border was applied to all years, and all municipalities were classified into equal-size quintiles based on population density. Both municipalities and physicians were longitudinally observed.ResultsBetween 1994 and 2014, the number of physicians per 100,000 population increased by 31.8% in the most urban group of municipalities and 17.4% in the most rural group. The average age of physicians was highest in the most rural and lowest in the most urban group. The difference in average age between the urban and rural physicians widened from 2.1 years in 1994 to 6.0 years in 2014. This disparity is particularly pronounced among hospital physicians (from 1.5 years in 1994 to 7.6 years in 2014). In the most rural group, the number of hospital physicians younger than 40 years old has decreased by 59.4%, while the number of those 55–70 has grown by 153% and the number older than 70 years old by 41.0%. Between 1994 and 2004, only 23.0% of hospital physicians younger than 40 years old were retained in the most rural group; the retention rate fell to 19.3% between 2004 and 2014, while the rates increased in older physicians.ConclusionsThe uneven distribution of physicians is increasing in Japan, as is the aging of rural hospital physicians. Shortage of physicians in rural areas may be more serious than that shown as their headcount.

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Results of physician licence examination and scholarship contract compliance by the graduates of regional quotas in Japanese medical schools: a nationwide cross-sectional survey

Cited by 14 publications

References 16 publications

How is increased selectivity of medical school admissions associated with physicians’ career choice? A Japanese experience

How is increased selectivity of medical school admissions associated with physicians’ career choice? A Japanese experience

The Academic Performance of Scholarship Students during Medical School

Aging of hospital physicians in rural Japan: A longitudinal study based on national census data

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