Koike Soichi, Matsumoto Masatoshi, Ide Hiroo, Kawaguchi Hideaki, Shimpo Masahisa, Yasunaga Hideo
Division of Health Policy and Management, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
BMC Med Educ. 2017 May 8;17(1):83. doi: 10.1186/s12909-017-0919-y.
Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice.
We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification.
It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine.
Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.
建立和管理委员会认证体系是许多国家共同关注的问题。在日本，委员会认证体系正在修订。本研究的目的是描述内科专科医师委员会认证的现状，确定与维持委员会认证相关的因素，并调查医师从医院转向临床执业时执业领域的变化。
我们分析了来自医师、牙医和药剂师调查的2010年和2012年数据。我们进行了逻辑回归分析，以确定2010年至2012年间与维持委员会认证相关的因素。我们还分析了具有委员会认证的医院医师从医院到诊所职业转变的数据。
寻求委员会认证的医师在其职业生涯早期这样做是常见的。女性和在学术医院以外地点工作的医师维持委员会认证的几率较低，而在亚专业执业领域的医师几率较高。在2010年至2012年间转向诊所的具有委员会认证的医院医师中，95.8%仍留在内科或其亚专业领域，87.7%维持委员会认证，但从亚专业领域转变为更普通的内科执业。
内科委员会认证体系的修订必须考虑不同的医师职业路径，包括职业生涯中期的变动，同时维持认证质量。这将有助于确保专科医师的数量和分布充足。为满足对全科医师日益增长的需求，设计培训全科专科医师的项目很重要。
