Topic of the conference was evaluation of attitude and competence of candidates on the entrance examination, and concrete procedures of interview, essay test and so on and notes for assessing process were discussed.Further improvement in the method of interview and essay test and the standardization of their assessment and clarification of the validity of these tools by accumulation of their follow-up data were important.

We have reviewed the Recommendations on Undergraduate Medical Education published by the General Medical Council (GMC) of the United Kingdom in 1993, and have visited the University of Leicester to see how they have revised their medical course to take account of the GMC's recommendations. The aim of the GMC's recommendations is to promote a culture of self directed learning which will be of value to the future medical practitioners in their postgraduate careers. To achieve this the GMC recommends a reduction in the burden of factual information delivered to the student while promoting learning through curiosity and the exploration of knowledge. The students are given an integrated view of clinical and basic scientific disciplines. The University of Leicester has reorganised its medical teaching around modules relating to body function rather than the traditional disciplines, with contributions being made by clinicians and basic scientists in the same module. The new course places great emphasis on carefully guided and structured self directed study and a reduced number of lectures. Clinical skills are introduced early in the curriculum, while a deeper understanding of selected scientific disciplines are achieved by a series of special study modules where the students undertake supervised scientific research.

  We analyzed the career options of students who had graduated from Kyoto University School of Medicine from 2002 through 2009. The percentage of graduates who chose to train as junior residents in the Kyoto University Hospital group, including Kyoto University Hospital and its related hospitals, did not differ between before and after the new clinical training system was enforced; however, after the start of the new system, the percentage of graduates choosing to train at Kyoto University Hospital significantly decreased, and the career options of graduates at hospitals related to the Kyoto University Hospital became diversified. An analysis of physicians who had trained at the Kyoto University Hospital group as junior residents from 2004 through 2008 showed no significant difference in the percentage of senior residents at the Kyoto University Hospital or its related hospitals who had graduated from Kyoto University or any other universities.

Clinical clerkships have been gradually introduced in medical schools in Japan. Because all students do not rotate through the same departments, the satisfaction of medical students differs among the departments, although the underlying reasons for such differences are unclear. To investigate the factors associated with student satisfaction with clinical clerkships, we performed a questionnaire survey.1) Questionnaires were distributed to 99 fifth-year medical students at Kyoto University Medical School. The questionnaire consisted of Likert-type 5-level scales of satisfaction, clinical clerkship assignments, and the attitudes of clerkship supervisors and other attending staff. Eighty-nine students responded.2) The independent factors for students' satisfaction were the attitude of attending staff (beta coefficient, 0.34), the attitude of the clerkship supervisor (0.30), and the frequency of physical examinations (0.09).3) Twenty-two of the 34 students who expressed the lowest level of satisfaction (level 1) reported that "the attending staff rarely had contact with students."4) Factors not associated with satisfaction were: whether the rotation was in internal medicine or surgery; whether the rotation was in a community hospital or a university hospital, and the department.5) These results suggest that medical students are satisfied with a clerkship if they perform frequent physical examinations and if the attending staff have an enthusiastic attitude.

To clarify the experience in clinical practice of students at Osaka University Medical School, a questionnaire survey was performed according to the International Classification of Primary Care. More than half of the students had observed only 6 of the 23 reasons for seeking primary care such as headache and hypertension but had not experienced 17 of the 23 reasons, such as cough and abdominal pain. Most students had observed malignancy and chronic diseases, but more than half had only knowledge of 54 of 105 diseases such as appendicitis. In conclusion, medical students' experiences in clinical practice are not well balanced.

1) Common training for the introduction of research and the elective and individual guidance for research should be devised in a manner attractive to graduate students of medicine.
2) To train researchers, a graduate school of clinical medicine should be established as a professional school, separate from an ordinary graduate school.
3) To promote basic medical sciences, the capacity of graduate schools of basic medical sciences should be reduced despite the number of teachers and the bold plan for the financial support of students.

1) We compiled lists of accredited training hospitals for postgraduate education from the matching program list and of hospitals that employ board-certified specialists in emergency medicine.We then evaluated the number of training hospitals that employ board-certified specialists.
2) There are 1072 accredited hospitals for postgraduate education. However, only 546 (50.8%) of these hospitals employ board-certified specialists in emergency medicine.
3) Accredited training hospitals with emergency-medicine specialists are prevalent in Okinawa, Tokushima, and Kagawa prefectures.However, the prevalence of these hospitals is surprisingly low in metropolitan areas.

Qualitative research has gained greater attention in medical research, but it might seem to be unscientific because qualitative and quantitative research methods are grounded in different paradigm.
In this article, we introduce three major qualitative research methods frequently used in studies of patient-doctor communications: 1) in-depth interviews; 2) focus group interviews and, 3) semi-structured interviews.
Each qualitative research method has different or common advantages and disadvantages, and which methods should be used depends on the study objectives. Qualitative research and quantitative research are complementary: while quantitative research explains the prevalence or variation of an issue, qualitative research explains the reasons or processes of that prevalence or variation. Combination of the two methods enables the gathering of more comprehensive and explanatory results.

In the medical interview portion of the objective structured clinical examination (OSCE), we usually use both detailed checklists and a global rating scale to evaluate a student's performance. In the present study we investigated a problem with the detailed checklists.
1) The quality of the assessment of information-gathering capability was investigated in a station for the medical interview in a pharmaceutical OSCE.
2)A video review revealed a 7% error in the detailed checklist assessment at the OSCE station.
3) Following the interview in this study, the students wrote down the information they had gathered. These results differed by 15.6% from those of the detailed checklist assessment at the OSCE station.
4) In the present style of OSCE, the detailed checklist assessment at the OSCE station is problematic. The style in which the students write down the gathered information after the interview might be re-considered.

Approximately 80 % of medical students start medical training in a specific department at their medical school hospital after graduation and do not experience medical practices in other departments. Therefore, a questionnaire survey of conditions in and opinions about the present postgraduate clinical training was conducted among trainees at Osaka University Hospital. Questionnaires were returned by 136 of the 156 trainees (87.2 %). Their average income was ¥255, 000 per month. Approximately 85 % of trainees had less than 1 day's vacation each month. Forty percent of trainees were not satisfied with the present postgraduate clinical training course, because 75 % felt that their training life was too busy and did not allow them to observe a variety of diseases. These results suggest that the postgraduate medical training program in university hospitals should be changed to include various disciplines in several departments in cooperation with other hospitals and clinics for outpatients. To raise the quality of postgraduate medical training, an education system for trainees must be established and duties unrelated to medical examinations and treatment must be reduced.