[A Trained-in-Japan Anesthesiologist Going Through Anesthesia Training in the United States : What Adjustments Should be Made for Upcoming Renewal in Anesthesia Board Certification in Japan?].

We reviewed the anesthesiology training in the United States from the viewpoint of Japanese Anes- thesiologists. The Accreditation Council for Graduate Medical Education (ACGME) strictly supervises anes- thesiology residency programs in the U.S. Recently, the ACGME has become stricter on training supervi- sion, and American Board of Anesthesiology (ABA) revised its board examination system. The quality of anesthesia training in the U. S., how- ever, is decreasing because of new regulations. Addi- tionally, in the continuing economic recession, hospitals have started to hire more nurse anesthetists (CRNA) with cheaper salary than anesthesiologists. This situa- tion led more anesthesiology residents to seek an extra year of subspecialty fellowship training and research experience. This trend will come to Japan in the near future, for which we should be well prepared. As the first step, the process for Japanese Anesthesiology Board Recertification should be modified. Continuing medical education should be mandatory for each re- newal with recertification examination. Second, the number of residents and the quality of each program should be strictly supervised by a third party. Lastly, we should encourage residents to seek subspecialty training and more research experience to become bet- ter anesthesiologists.