[Roles and perspectives of the clinical laboratory in the new compulsory program for postgraduate clinical training: a report from Kobe University Hospital].

After the induction of the new compulsory program for postgraduate clinical training in 2004, Kobe University Hospital has changed dramatically, far more than expected. The reform of incorporating national universities also started in the same year. Accordingly, doctors and medical technologists (MT) working in the clinical laboratory have been looking for ways to contribute to the new clinical training program and hospital reforms. There are three big issues: Firstly, the hospital systems have been changing qualitatively due to the decreased numbers of residents. The clinical activities in the university hospital had largely depended on residents for various work in the old program. The numbers of residents, however, has fallen to less than half in the new program. In addition, there has been a growing consensus that university hospitals should refrain from loading excessive work and responsibilities on residents. These changes directly resulted in transferring the burden of residents onto senior doctors and faculty staff. Secondly, the roles of the clinical laboratory and the intensity of activity have been changing with the need of cooperating with hospital reforms caused by the new clinical training program and incorporating process. To improve or support the clinical activities and economical efficiency of the university hospital as an independent corporation, MT and other co-medical staff have been encouraged to help with various jobs which had been done by residents in the old system. Thirdly, how should we present updated and attractive training programs to medical students and postgraduates who are interested in becoming CPs? In this report, I introduce our new department of evidence-based laboratory medicine, and propose a few novel pathways for CPs, which I hope will show the new direction for the future of CPs.