# Outline of 2010 System Reform

## (1) Flexible Training Program

• Training program standards are revised to offer more flexibility while maintaining the basic ideas and achievement goals of clinical training.

• “Compulsory courses” comprise of internal, emergency, and community medicine. Surgery, anesthesiology, pediatrics, obstetrics and

• Training periods are no less than 6 months for internal medicine, no less than 3 months for emergency medicine, and no less than 1 month for community medicine.

• Training programs are available for those who wish to become obstetricians or podiatrist (hospitals with 20 or more recruitment quotas for internship).

## (2) Reinforcement of standards for designation of core clinical training hospitals

• Requirements for designation of core clinical training hospitals includes the annual number of inpatients being 3,000 or more and placement of 1 or more preceptors for each of 5 interns, etc.

## (3) Revision of recruitment quotas for internship

• Establishment of a limit on the total number of recruitment quotas that reflects the number of training applicants and the limit of recruitment quota in each prefecture for conducting appropriate regional arrangement of medical interns.

• A recruitment quota of each hospital is set after taking into consideration the actual results of accepting interns in the past and dispatching doctors, etc. and making necessary adjustment with the prefectural limit.

## (4) Provision for the review

• Provisions of Ministerial Ordinance on Clinical Training shall be reviewed within 5 years from the enforcement of Ordinance, and necessary measures to be taken.

## Outline of 2015 System Reform

## (1) Appropriate core clinical training hospitals

• Appropriate core clinical training hospitals are clearly defined as those having an environment capable of training for most of the achievement goals and having overall management of, and responsibility for, interns and training programs.

## (2) Appropriate clinical training hospital groups

• Groups consist of those capable of forming various abilities related to frequently occurring diseases, etc.

• The geographical coverage of a hospital group is basically within the same prefecture and secondary medical district.

## (3) Cases required for core clinical training hospitals

• Newly applied hospitals with the annual number of inpatients being less than 3,000, but 2,700 or more that are deemed capable of providing high-quality training, are assessed through on-site evaluation for the time being.

## (4) Career development support

• Smooth interruption/resumption of clinical training according to various career paths, including pregnancy, childbirth, research, and study abroad, etc.

## (5) Revision of recruitment quota setting

• Reduction of the percentage of recruitment quotas for internship applicants (from approx. 1.23 times (FY2013) to 1.2 times for the time being (FY2015) and 1.1 times towards the next revision)

• Partial revision of the calculation formula for the upper limits of prefectures (the aging rate and the number of doctors per unit population are newly considered)

• The actual results of dispatching doctors of university hospitals, etc. is considered when setting a recruitment quota for each hospital.

## (6) Responses to regional limits and strengthening of roles of prefectures

• Limits are included to enable a prefecture to adjust the quota for each hospital within the upper limit of the prefecture with consideration given to regional limits and the actual results of dispatching doctors, etc.

* Necessary reviews will be made within 5 years after the enforcement of this revised system.

#### Re-education Training for Administratively Punished Doctors, etc. (Medical Practitioners Act, etc.)