Introduction: The aim of this study was to clarify the process by which family physicians succeed their parents in their family's clinic and issues that successors experience during this process.Methods: Subjects were certified family physicians in Japan who either succeeded their parents in their clinics or were working regularly at their family's clinic and were planning to succeed their parents. Participants were recruited through a certified family physician mailing list or privately contacted, and participated in a semi-structured individual interview. The text of the interviews was thematically analyzed.Results: Twelve participants were interviewed. All were male. Seven participants succeeded their parents. Family physicians succeeding their parents in their clinics felt implicit expectations towards succession from their family members and communities, which made them think that succession was the goal. They realized that they had no ability to decide on the timing of succession, clinics have customs and continuity, predecessors have different ideas about professionalism, and family businesses are complex. They felt conflict, especially about predecessors, in their emotions towards family members and ideas based on professionalism.Conclusion: We clarified the process of succession by family physicians in their family's clinic, and the issues and conflicts they face during this process.

To provide appropriate healthcare services to all patients, strong interprofessional partnerships are essential. We have developed a voluntary community-based interprofessional education (IPE) program for medical students and other healthcare students. In this program, students from different healthcare fields conduct fieldwork together in small groups. The purpose of this study was to determine what participants learned through the IPE program.
1) Five researchers with different healthcare backgrounds analyzed all (63) participants' postprogram reports (collected since 2002) and extracted and categorized items describing what the participants had learned.
2) The categories of items learned included the roles of healthcare professionals, cooperation among healthcare professionals, the meaning of “community medicine”, the difficulty and the importance of communication, and a sense of fellowship with participants of other backgrounds.
3) These items indicate our IPE program helps students learn about interprofessional cooperation by observing actual examples of cooperation in the community and by working with students from different healthcare fields.

Background: Activity in international conferences is essential for the academic progress of primary care in Japan. We aimed to clarify the obstacles Japanese university-based primary care physicians face in attending and presenting at international conferences.
Methods: We conducted a questionnaire of 10 residents and 22 physicians in the Department of General Medicine and Primary Care at the University of Tsukuba.
Results: The primary obstacle preventing conference attendance was English language skills. A secondary obstacle was insufficient time off work.
Conclusions: Additional support in English language skills and time off work is necessary to promote attendance at international conferences.

Medical students must have motivation to participate in medical care during clinical clerkships. How much interest students have in each department might be a factor in making them more active in clerkships. To make clerkships more effective, we performed a questionnaire survey to investigate the relationship between students' interest in each department and their eagerness in clinical clerkships and to investigate factors to increase their eagerness.
1) Questionnaires were distributed to 92 sixth-year medical students at the University of Tsukuba. The questionnaire consisted of 6-point Likert scales of 4 specific student attitudes in clerkships. We asked the same questions about clerkships at medical departments that each student found more or less interesting.
2) We asked the students to report anecdotes about when they were motivated to learn more in the clerkships. We grouped similar answers into categories.
3) The response rate was 94%. The students were more eager in departments they found more interesting than in departments they found less interesting.
4) Thirty-eight students reported a total of 56 anecdotes. Among the categories, questions or words of encouragement from patients were mentioned in 29 anecdotes, and devoted faculty members were mentioned in 9 anecdotes.
5) These results suggest that medical students' eagerness in clinical clerkships could be increased by deepening their interest in medical departments and by improving communication with patients and physicians.

This study explored the general public's perception of the clinical competence of residents. Methods: Individual interviews of laypersons, medical students, and residents and focus-group interviews of residents were conducted. Results: Individual interviews revealed the belief that residents acquired various clinical skills immediately after passing the national examination for medical practitioners. These skills included: assessment of the need for referrals, on-call jobs for after-hours and emergency services, interpreting X-ray films, performing cardiopulmonary resuscitation, performing surgery for appendicitis, and treating bone fractures and joint dislocations. Focus-group interviews revealed differences between residents and laypersons in the perception of residents' clinical skills. These skills included: general knowledge of diseases and medications, guidance about lifestyle after discharge, physical examinations, explanation of treatment, diagnostic imaging, and knowledge of or expertise in other medical professions. Conclusion: Laypersons and medical personnel have different perceptions about the clinical competence of residents.

Introduction : To reveal patients' impressions of physicians working short-term in community clinics, and to explore methods for physicians to work short-term in community clinics.
Methods : We conducted a qualitative analysis of recordings of individual interviews performed on patients in community clinics using a partially revised SCAT (Steps for Coding and Theorization) method.
Results : Patients indicated that they felt reassured by the constant presence of a chief physician at community clinics. They expected care within the scope of primary care, but were not expecting every element within this scope to be met. Patients had the attitude of accepting the current situation and were selecting how to receive medical care from the available options based on their personal priorities.
Conclusion : Physicians working short-term in community clinics were satisfying a portion of the patients' needs. Providing care within the scope of primary care and taking the initiative in getting to know patients are essential elements for physicians working short-term in community clinics.

1) We evaluated the clinical experiences of 102 medical students who completed clinical clerkships at the University of Tsukuba, by analyzing their self-assessments on the clinical evaluation form normally used for the postgraduate residency program.
2) The medical students participated in the management of a broad range of diseases. However, in most cases, their participation was only partial.
3) To improve the continuity between the undergraduate and postgraduate medical education systems, it is important to expand the amount of hands-on participation of medical students in medical practice.