Japan tests medical students for approachability

Karen Hebert, Bristol

Japanese medical students must prove that they are approachable before they can qualify. This reflects the Japanese medical profession’s objective to move away from just expecting students to acquire knowledge toward effective interaction with patients.

From April 2005, all of the 108 Japanese universities that have a medical or dental school will have to implement the Common Achievement Test (CAT) for their students. The examination will test students’ communication skills through a mock consultation with a patient.

PASCAL GOETGHELUCK/SPL

All students in their fourth year, their final preclinical year, will take the computer based test, consisting of mainly multiple choice questions, and an objective structured clinical examination. Students who fail can retake the exam, but should they fail twice they will be advised to seek different work.

“This will be an important step toward fostering doctors who will be able to provide high quality, patient centred medical care,” an official at the medical education division of the Education Ministry said. “There will be much emphasis on judging students on a uniform national standard.”

Japanese medical education has changed considerably since the 1990s. The National Model Curriculum has been introduced. This includes more than 1200 objectives, including knowledge base, basic clinical skills, and communication skills. A more robust system has been set up with regards to the requirements of the clinical clerkships.

Hirotaka Onishi, vice chairman of the international relations committee, Japan Society for Medical Education, explains, “Currently the Japanese media cover many negative aspects of medical practice, such as a number of malpractice cases and inappropriate patient-doctor communication cases. Physicians used to be called sensei [teacher or mentor] but such respect has been lost since the 1980s. Quality of care and medical education have become critical issues since the rapid growth of the economy. The CAT will make a strong impact on the preclinical curriculum.”



studentBMJ 2005;13:89-132 March ISSN 0966-6494