1) Medical education in Malaysia is strongly affected by United Kingdom, which previously governed this area. Malaysia and UK have similarities in admission of high school graduates to medical schools, five-year curriculum emphasising primary care, and certifying graduation by internal and external examiners.
2) Twinning programme is a general trend in Malaysia; offering medical degree from overseas after completing part of the partner school's curriculum in Malaysia.
3) International Medical University, where the author had worked from 2003 to 2005, reveals strong enthusiasm in medical education because it sends students to undergraduate clinical education in 27 different partner medical schools in Western countries, provides hybrid curriculum with problem-based learning in preclinical years, moves towards outcome-based curriculum, and promotes several medical education research projects.
4) Thus, medical education in Malaysia has made significant and innovative progress through severe competition with surrounding areas as well as western countries.

1) The International Ottawa Conference on Medical Education is one of three international conferences for medical education, along with the annual meetings of the Association for American Medical Colleges and the Association for Medical Education in Europe.
2) Topics addressed at the 12th Ottawa Conference were interprofessional education, faculty development, reflective practice, standard settings for clinical skill assessment, key feature problems, and multisource (360 degree) feedback.

The Indonesian government and authorities, moving rapidly in 2004 to rectify Indonesia's chronic shortage and regional imbalance in the number of physicians and to improve the standard of medical care, enacted the Medical Practice Act 2004 and established the Indonesian Medical Council (IMC). The IMC drew up a list of standard competencies to be acquired by all medical graduates; on the basis of this list, representatives from the Ministries of Health and National Education, medical school faculties, and the Indonesian Medical Association drew up the National Competency-Based Curriculum, which was subsequently approved by the IMC and adopted by all medical schools. This curriculum markedly improved Indonesia's core curricula for undergraduate medical education. By requiring that the medical competence of all physicians be evaluated before they receive a license to practice and requiring that all physicians renew their licenses every 5 years, the IMC has taken 2 major steps toward ensuring patient safety and improving the quality of medical services.

Purpose : The objective of this qualitative study was to clarify rewarding and positive aspects of comprehensive community care practices by clinic nurses.
Methods : Semi-structured interviews were conducted for six nurses who had been working for more than five years at community-based clinics in the surrounding areas of Tokyo. Responses were analyzed using the Modified Grounded Theory Approach proposed by Kinoshita. Concept diagrams were drawn from the themes.
Results : Nurses regarded the integrated care of individual patients, their family and community as meaningful and rewarding because they were able to provide truly holistic care. They were also satisfied with “value of individual experiences of nurses”, “frontier spirit of community nurses providing pathless integrated care”, “appropriate work-life balance”, “independent position in the clinic” and “community-based team approach including medicine, health and welfare”.
Conclusion : Nurses felt easier providing their psychosocial intervention in a community-based clinic as part of a medical system. Nurses obtained rewards by using their holistic care ability. Since nurses and family physicians have similar perspectives with respect to patient-centered care, some nurses felt conflicts with their physicians, because patient-centeredness is not the only strength of such nurses.

Objective: To investigate the role and validity of the objective structured clinical examination (OSCE) for neurological screening (Neuro-OSCE) performed by medical students and to analyze the association between Neuro-OSCE score and student behavior for acquiring skills. Method: A 31-item Neuro-OSCE was created for systematic and time-saving screening of neurological findings. At Saga Medical School, 44 final-year students took a screening neurological examination course and performed Neuro-OSCE from August through October 1998. A questionnaire asked about self-educational behaviors, such as self-evaluation, mental concentration, and self-learning (knowlege-based), and self-practicing time. The relationship between Neuro-OSCE score and self-educational behaviors were analyzed. statistically. Results: Cronbach's coefficient alpha was 0.731, which indicated fair internal validity. The mean Neuro-OSCE score was 51.2± 6.6 (SD). Neuro-OSCE score was correlated with self-practicing time and mental concentration but not with self-learning time or self-evaluation. Conclusion: Our Neuro-OSCE has construct validity in the psychomotor domain from a taxonomic viewpoint because the Neuro-OSCE score was correlated with self-practicing time rather than self-learning time. Mental concentration was better a self-assessment method than was self-evaluation. However, setting self-educational goals for neurological examination is probably too difficult at the undergraduate level. Objective assessment by Neuro-OSCE is expected to foster relevant learning behavior.

OBJECTIVE: To evaluate an undergraduate curriculum of communication skills by measuring satisfaction of outpatients whom final year students had examined.
METHODS: Cross-sectional surveys were conducted in General Medicine Clinic (GMC) of Saga Medical School (SMS) Hospital in 1999 and 2001. After the clinical clerkship in wards in fifth year, final year students experienced the two-week GMC clerkship, including seven hours of small group lecture in 1999, but partly converted into eight hours of small group discussion with a tutor in 2001. Six items in American Board of Internal Medicine Patient Satisfaction Questionnaire were selected as a validated instrument and incorporated into repeated measures ANOVA.
RESULTS: A total of 177 students were evaluated by 688 outpatients. Overall average score was 3.49+/-0.82. Average score in 2001 was significantly higher than that in 1999 (p<0.001; 3.58+ /-0.76vs 3.36+/-0.87) . The scores of“encouraging and answering questions”and“clear explanations”items were significantly lower than those of other items (3.21+/-0.98 and 3.37+/-0.92; Least Significant Difference) . The interaction between gender and years of curricula (1999 and 2001) was significant (p<0.001) ; female students showed remarkable improvement from 1999 to 2001 (Cohen's delta=0.67) .
CONCLUSIONS: Patient satisfaction scores indicated that undergraduate curriculum for communication skills in SMS improved from 1999 to 2001. Newly implemented small group discussion was a possible reason for the improvement, especially in female students. Further training for the skills of encouraging and answering questions and clear explanations will be the next step.

Introduction : The objective of this research was to evaluate and to seek out factors that affect the usefulness and necessity of postgraduate community-based training programs in Saku Central Hospital (SCH) after the implementation of the New Postgraduate Training System for Physicians (NPTSP)
Methods : A questionnaire survey of physicians who entered the residency program of SCH between 1996 and 2007 was conducted.
Results : The questionnaire was sent to 111 physicians, and responses were received from 73 (65.8%). Of the reasons for selecting SCH for residency training, three showed significant increases after the implementation of NPTSP : the training system, the general medicine department/general outpatient clinic, and the overall ambience of the SCH staff. The usefulness of the community-based training program showed a 3.77 times higher odds ratio (OR) in male residents (95% CI, 1.31-10.9). Necessity was decreased after the implementation of NPTSP, showing an OR (95% CI) of 2.99 (1.05-8.55).
Conclusion : Of the reasons why residents selected SCH, the management system for the residency program and the environment for general practice in the hospital became more important after the implementation of NPTSP. The need for a community-based training program in SGH was decreased after NPTSP emphasized primary care.

Since medical education programs in Korea and Japan seem to mutually influence each other, this review article provides a history of Japanese medical education, focusing on the way in which it influenced and was influenced by Korean medical education. In the late 19th century, the University of Tokyo established the core medical school, disseminating its scholarship and system to other medical schools. In the early 20th century, the balance between the quality and quantity of medical education became a new issue; in response, Japan developed different levels of medical school, ranging from imperial universities to medical colleges and medical vocational schools. After World War II, all of Japan's medical schools became part of the university system, which was heavily regulated by the Ministry of Education (MOE) Standard for the Establishment of Universities. In 1991, MOE deregulated the Standard; since 2000, several new systems have been established to regulate medical schools. These new approaches have included the Model Core Curriculum, 2-year mandatory postgraduate training, and a medical education accreditation system. Currently, most medical schools are nervous, as a result of tighter regulatory systems that include an accreditation system for undergraduate education and a specialty training system for postgraduate education.
Accreditation ; Asian Continental Ancestry Group* ; Curriculum ; Education ; Education, Medical* ; Fellowships and Scholarships ; Humans ; Japan ; Korea ; Schools, Medical ; World War II

Increased emphasis on community-based education in medicine requires close collaboration with and cooperation from general practitioners. This study examined what motivates community physicians to participate in office-based education, to explore the most appropriate method for recognizing physicians' efforts and keeping them motivated with their precepting role. A large majority of respondents to a questionnaire survey thought that the opportunity to learn from their own teaching was an important reward. When the preceptors were asked what support would be most appropriate, a teaching certification plaque, continuing medical education courses, and a title were ranked highest, while financial reward was listed as the least important. Considered most essential by community preceptors were constructive feedback from students, medical-school instructors' understanding of the importance of community-based medicine, and the instructors' enthusiastic promotion of primary-care education.

To seek longitudinal changes in metacognitive processes through problem-based learning (PBL), we analysed the contents of all comments written reflectively by the third-year students after they finished discussions in each PBL session. After dividing their comments into meaningful units, we focused on two major thematic categories and five sub-categories to be analysed.
1) The number of units decreased significantly (chi-square: p=0.02).
2) Only the proportion of units categorised as “comprehension” in “individual learning” showed significant increase (Bonferroni: p<0.001).
3) Comments in this category stated that “I don't understand so-and-so.”
4) The increase of “comprehension” as they experienced more PBL suggested that students' knowledge of ignorance as metacognition was fostered through sessions in medical PBL.