Goto Michiko, Kondo Satoshi, Tanizaki Ryutaro, Yamamoto Norihiko, Wakabayashi Hideki
Department of General Medicine Mie University Graduate School of Medicine Tsu Mie Japan.
Department of Community-Based Medicine Nagoya City University Graduate School of Medicine Sciences Nagoya Aichi Japan.
J Gen Fam Med. 2025 May 1;26(4):346-354. doi: 10.1002/jgf2.70021. eCollection 2025 Jul.
To address the shortage of healthcare professionals in rural regions of Japan, Longitudinal Integrated Clerkship (LIC) programs were introduced with the objective of training community-oriented generalists. LIC provides students with a longitudinal approach to clinical education, fostering a commitment to primary care careers. Studies have shown that LIC graduates are more likely to work in rural settings, with a significant proportion pursuing primary care. The LIC model has recently garnered increased interest, leading several institutions in Japan to adopt this educational framework to enhance regional healthcare delivery.
This study employed semi-structured interviews with three sixth-year medical students who completed the LIC program between 2014 and 2020. Interview transcripts were subjected to thematic analysis to identify factors influencing career choices.
The analysis revealed six key themes that influenced the career decisions of the LIC participants. The students' interactions with mentors and their involvement in long-term patient care emerged as pivotal experiences, reinforcing their dedication to community healthcare and primary care. The participants reported an enhancement of their clinical competencies and a growing confidence in their roles as generalists.
Despite the limited number of LIC participants, the findings indicate that the program effectively promotes interest in general practice careers. The study identified potential areas for program enhancement and elucidated the mechanisms by which LIC influences career decision-making. Additionally, the results highlight the importance of educational strategies based on established learning theories, which foster students' professional growth, adaptation to community healthcare, and reinforce their commitment to primary care.
为解决日本农村地区医疗保健专业人员短缺的问题,引入了纵向综合实习(LIC)项目,旨在培养以社区为导向的通才。LIC为学生提供纵向的临床教育方法,培养他们从事初级保健职业的意愿。研究表明,LIC毕业生更有可能在农村地区工作,其中很大一部分人从事初级保健工作。LIC模式最近受到了越来越多的关注,促使日本的几家机构采用这一教育框架来加强区域医疗服务。
本研究对2014年至2020年间完成LIC项目的三名六年级医学生进行了半结构化访谈。对访谈记录进行了主题分析,以确定影响职业选择的因素。
分析揭示了影响LIC参与者职业决策的六个关键主题。学生与导师的互动以及他们参与长期患者护理成为关键经历,强化了他们对社区医疗保健和初级保健的奉献精神。参与者报告说,他们的临床能力有所提高,对自己作为通才的角色也越来越有信心。
尽管LIC参与者数量有限,但研究结果表明该项目有效地促进了对全科医学职业的兴趣。该研究确定了项目改进的潜在领域,并阐明了LIC影响职业决策的机制。此外,研究结果强调了基于既定学习理论的教育策略的重要性,这些策略促进学生的职业成长,使其适应社区医疗保健,并强化他们对初级保健的承诺。