Matsumoto Masatoshi, Takeuchi Keisuke, Tanaka Junko, Tazuma Susumu, Inoue Kazuo, Owaki Tetsuhiro, Iguchi Seitaro, Maeda Takahiro
Department of Community-Based Medical System, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
BMJ Open. 2016 Apr 15;6(4):e011165. doi: 10.1136/bmjopen-2016-011165.
Given the shortage of physicians, particularly in rural areas, the Japanese government has rapidly expanded the number of medical school students by adding chiikiwaku (regional quotas) since 2008. Quota entrants now account for 17% of all medical school entrants. Quota entrants are usually local high school graduates who receive a scholarship from the prefecture government. In exchange, they temporarily practise in that prefecture, including its rural areas, after graduation. Many prefectures also have scholarship programmes for non-quota students in exchange for postgraduate in-prefecture practice. The objective of this cohort study, conducted by the Japanese Council for Community-based Medical Education, is to evaluate the outcomes of the quota admission system and prefecture scholarship programmes nationwide.
There are 3 groups of study participants: quota without scholarship, quota with scholarship and non-quota with scholarship. Under the support of government ministries and the Association of Japan Medical Colleges, and participation of all prefectures and medical schools, passing rate of the National Physician License Examination, scholarship buy-out rate, geographic distribution and specialties distribution of each group are analysed. Participants who voluntarily participated are followed by linking their baseline information to data in the government's biennial Physician Census. Results to date have shown that, despite medical schools' concerns about academic quality, the passing rate of the National Physician License Examination in each group was higher than that of all medical school graduates.
The Ethics Committee for Epidemiological Research of Hiroshima University and the Research Ethics Committee of Nagasaki University Graduate School of Biomedical Sciences permitted this study. No individually identifiable results will be presented in conferences or published in journals. The aggregated results will be reported to concerned government ministries, associations, prefectures and medical schools as data for future policy planning.
鉴于医生短缺，尤其是在农村地区，自2008年以来，日本政府通过增加地区配额迅速扩大了医学院学生的数量。配额录取的学生目前占医学院录取学生总数的17%。配额录取的学生通常是当地高中毕业生，他们获得县政府的奖学金。作为交换，他们毕业后要在该县，包括农村地区临时执业。许多县也为非配额学生提供奖学金项目，以换取他们毕业后在该县的实习。这项由日本社区医学教育理事会进行的队列研究的目的是评估全国配额录取系统和县政府奖学金项目的成果。
研究参与者分为三组：无奖学金配额组、有奖学金配额组和有奖学金非配额组。在政府各部门和日本医学院协会的支持下，以及所有县和医学院的参与下，分析了每组学生的国家医师执照考试通过率、奖学金买断率、地理分布和专业分布。通过将他们的基线信息与政府两年一次的医师普查数据相链接，对自愿参与的参与者进行跟踪。迄今为止的结果表明，尽管医学院担心学术质量，但每组学生的国家医师执照考试通过率都高于所有医学院毕业生的通过率。
广岛大学流行病学研究伦理委员会和长崎大学医学研究生院研究伦理委员会批准了本研究。不会在会议上展示或在期刊上发表任何可识别个人身份的结果。汇总结果将作为未来政策规划的数据报告给相关政府部门、协会、县和医学院。
