Under the current postgraduate clinical training system for physicians, three principles have been emphasized in its basic tenets; cultivation of character appropriate for physicians, generation of awareness to the societal role of medical science and healthcare, and mastery of basic clinical skills needed to respond appropriately to injuries and illnesses frequently encountered in general practice. In accordance with its quinquennial review rule, the Clinical Training Committee under the Medical Caucus of the Healthcare Professions Council released draft revisions of a notification published by the Director general of the Health Policy Bureau of the Ministry of Health, Labor and Welfare in March, 2018. The document is entitled "On the operation of the ordinance concerning the postgraduate clinical training prescribed in the paragraph (1) of Article 16-2, Medical Practitioners Act" .　A Key distinction of the revised draft is new learning outcomes featuring core values shared by physicians: commitment to physicians' societal mission of public health, altruistic behavior, respect for humanity, and maintaining one's own integrity. Another key distinction is securement of longitudinal consistency in the set of required faculties, from medical school curriculum to continuing professional development programs. Further improvements in systems and environments to enhance devotion to life-long learning are needed.

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Medical education towards a specialty is a core stage of training for medical doctors. The specialty training system in Japan was initially organized by various academic societies and was recently integrated under Japan Medical Specialty Board, which was established in 2014. From April 2018, a revised specialty training system will begin and be based on new program guidelines. Its main concepts are professional autonomy, quality assurance of the medical specialty board and trustworthy medical consultation. As with undergraduate education, global standards are recently required in postgraduate education. Consistent outcome policy throughout undergraduate and postgraduate education and workplace-based assessment can hopefully be established.

Medical education at college is the very first step of life-long learning as a medical doctor. Curricular reforms in Japan took place in the early 21st century, and can be exampled by the development of a model core curriculum, the emergence of the CAT (common achievement test) examination, the development of clinical clerkship and so on. The International accreditation of medical schools has just started spring of 2017. It highlights outcome-based education, which accelerates the connection of undergraduate education with postgraduate training.

A community-based medicine program in the postgraduate clinical training system has been offered as a mandatory program since 2004. Training sites range from clinical attachments in rural/remote areas to public health centers in the city. The role of the program director is important for enhancing the community-based medical program and raising resident doctors. Unique training programs have been carried out, such as medical training in the afflicted area of the earthquake/Tsunami disaster area as well as an exchange program between Hokkaido and Kagoshima residents. The Japanese healthcare system is drawing global attention and local demand. Enrichment of the community-based medicine program is vital for the human resource development that makes the Japanese healthcare system innovative and sustainable.

"Quality of education" has various definitions, and the definitions are classified mainly into five categories. Introducing the definition categories of "quality of education" , we analyze what aspects of the postgraduate clinical training system for physicians as an educational program have been reconsidered and redesigned. According to the analysis, we propose to introduce a programmatic assessment, which compose of several assessment methods, for evaluation at each stage of medical education from undergraduate to continuous professional development. Realizing such evaluation, we also propose to introduce a student/trainee assessment from a patient's perspective.

"The Ordinance of Ministry of Health, Labor and Welfare on Japanese Postgraduate Medical Training System" from 2020 was announced to each prefectural governor on July 3rd, 2018. This Medical Training system has been reviewed once every five years, and has been strongly aware of the consistency between the model core curriculum of the undergraduate medical education and the continuing professional development of Japan Medical Association. In this journal, Postgraduate Education Committee in Japan Society for Medical Education has published six installments of a series entitled "Japanese Medical Training System and Medical Education" . We reviewed the series and discussed medical education trends surrounding the postgraduate medical training system and issues in the committee. We will be reporting the information as part of the seventh installment of the series.