AMEE Ambassador Dr Hiroshi Nishigori reports on his own and Japan’s medical education activities.


By Dr Hiroshi Nishigori, Centre for Medical Education, Kyoto University, Japan.

My personal contribution to AMEE

Pic2_15-08-2014.jpg1. Participating in AMEE conferences annually and consecutively since 2004 (The most-joined medical educator in Japan)
2. Hosting annual banquets for Japanese participants in AMEE conference since 2009
3. Publishing papers in the academic journal “Medical Teacher” (Probably the most-published among all the Japanese medical educators at present). 'A model teaching session for the hypothesis-driven physical examination' by Nishigori H, Masuda K, Kikukawa M, et al. Medical Teacher. 2011;33(5):410–417.

News from Medical education in Japan
1. Undergraduate MedEd

1) Development of Common Achievement Test (started in 2005)
All the students of all the medical schools in Japan sit the same-format national examination just before starting clinical rotations. It consists of;
•    Computer-based test by MCQ or EMIs
•    Six to eight-station OSCE
It plays a role of quality assurance of students’ mastery of the preclinical core curriculum for patients seen by clinical-year medical students.Pic4_15-08-2014.jpg
2) Development of the Accreditation body (now in progress)
To make quality assurance of medical education, the organization called “Japan Accreditation Council for Medical Education” is now under development with the support of WFME. Professor Nara at Tokyo Medical and Dental University leads this project and all the 80 medical schools are planning to get accredited within 5 years. This is one of the hottest topics for Japanese medical educators.
3) Increased student enrolment
After introducing new postgraduate training in 2004 (described below), the issue of shortage of doctors in rural areas has getting worse. Many medical schools (especially in rural areas) developed a special category for entrance, and put students in this category under an obligation to serve for practice in rural communities for some periods. Under this reform, student enrolment in total in Japan has increased from (about) 8,000 to (about) 9,200 per year in this recent 5 years.Pic5_15-08-2014.jpg

2. Postgraduate MedEd
1) Renewal of postgraduate training (in 2004)
In 2004, we introduced an obligatory, rotating, 2-year clinical training for newly graduated doctors. The curriculum is quite similar to the Foundation Programme of the UK, though we do not use portfolio assessment.
2) Reform of JBMS (Japanese Board of Medical Specialties)
It is the accreditation body for specialty training, now reforming. As we have too many specialties in board certification (56), which are non-standardized and do not have any cap for the number of certified doctors, JBMS is planning to launch the new scheme of specialty training by 2017. JBMS also set 19 Basic board certifications including general practice, which is newly set. We have a lot of debate/discussion on how we develop general practice as specialty.

3. Continuing professional development
JBMS may be going to develop a standard for re-certification of all the specialties, though we need more time to make it proceed.
4. Japan Society of Medical Education (JSME)
1) Annual meeting
The number of submitted abstracts has been increasing and the conference programme book this year is about three times thicker compared to the one of ten years ago. We also welcomed the biggest number of international participants in this year’s annual meeting held in Wakayama.
2) Board-certified medical educator
We have just started a board certification system of medical education experts under JSME. Applicants have to complete three two-day medical education courses, get “pass” for the assignments, and submit educator’s/teaching portfolios, which are also evaluated. We may be the first country in the world to offer board certification for medical educators, so we are happy to share our experiences.

Some ideas which can contribute to AMEE
1. Development of the Japanese Branch of AMEE

1) Letting international medical educators know what is happening in medical education in Japan (like this report)
2) Supporting Japanese/international medical educators to have more academic communication with each other. We have already created a list of Japanese academic medical educators who can communicate in English under the APME-Net, Asian Pacific Medical Educator’s Network (Dujeepa in Singapore, Gominda in Sri Lanka and I are co-chairing this group).
3) Supporting Japanese medical educators to let them know AMEE related activities/materials (like AMEE guides or MedEd World), or to participate in AMEE conferences (especially for novices).
4) Making an academic exhibition of AMEE in the annual meeting of JSME and other medical education conferences.
5) This is an idea I have had since more than 5 years ago, so I personally am happy to work for it.

2. General comments
1) Comparing with other medical education conferences, I personally think that AMEE is the one which medical educators from all over the world can enjoy the most. I am sure that this is because AMEE executive members have worked (and are working) so hard for us, international participants, to make the conference enjoyable, inspiring and interesting. We greatly appreciate you.
2) However, many doctors (in Japan and other Asian countries) still have difficulty in communicating in English, especially for educational terms. I was involved in translating books, like “Practical Guide for Medical Teachers” or “Essential Skills for Medical Teachers”, but most English-fluent academic medical educators are too busy to do this sort of work. I am sure that support for translation definitely promotes AMEE activities in other part of the world (like Disney).
3) Or discussing how we overcome language/cultural barriers more (e.g. in a workshop) may be interesting. In a case of Japan, there are many wonderful research papers and books published in Japanese, but not known to international audiences, which definitely can contribute to AMEE and international medical educators. We do not know how we manage this issue, so I would be happy if I could discuss it with medical educators from other countries who have the same issue.

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