Introduction and Methods: An immediate effect of the physician shortage is the return to clinical work by physicians who had earlier left. Therefore, the needs of returning physicians were examined by means of a self-administered questionnaire. The subjects were clinicians working in Gunma Prefecture.
Results: About 50% of female physicians and 25% of male physicians had left clinical practice. The reasons given for leaving were “studying abroad” for most male physicians and “pregnancy and child-rearing” for most female physicians. More than 70% of physicians who had left clinical work felt uneasy about returning. The degree of anxiety after returning did not differ significantly between male and female physicians. Problems encountered by returning physicians involved “changes in medicines,” “changes and progress in technology and medical theories,” and deterioration of their “skills and techniques.” Moreover, returning physicians felt a need for increased “practical skills training.”
Discussion: Our study has clarified the needs of physicians returning to clinical work. The development and adoption of a simple system that will help physicians return to clinical practice is required.

Introduction: Lifelong learning is important for physicians because of patient safety and the need to constantly improve the quality of medical practice. However, few studies have investigated the specific topics that are required.
Methods: We examined the lifelong learning needs of physicians by means of a self-administered questionnaire that was completed by 595 subjects, who were clinical practitioners working in Gunma Prefecture.
Results: Subjects of all ages needed lectures about the use of evidence-based medicine in medical examinations, clinical studies and the interpretation of epidemiological data, and diagnostic imaging. The younger subjects had a greater need for learning about clinical skills and techniques, such as advanced cardiac life support／intensive care life support, abdominal ultrasonic diagnosis, and cardiac ultrasonic diagnosis. Regarding the ideal times for these lectures, some physicians working at Gunma University Hospital expressed a preference for weekdays after normal business hours, while others preferred the weekends.
Discussion: The lifelong learning needs of physicians were clarified. Because physicians work on different shifts and at different institutions, scheduling training sessions that everyone can attend is difficult, especially for those who are off-campus. The timing of the training sessions, as well as the content of lectures, must be considered. Ideally, sessions should be held more than once to accommodate the busy schedules of physicians. We believe that providing an opportunity for lifelong learning will help attract more people to a career in medicine and thereby help address the physician shortage.

Background: Hot spring inhalation and rock bathing are widely practiced in Europe, and immersion in water up to the shoulders is popular in Japanese balneotherapy. We designed a combination therapy of steam rock bathing and immersion in an open-air hot spring pool for allergic rhinitis.Methods: Data were obtained by anonymous questionnaires from 19 participants with perennial allergic rhinitis who underwent the combination therapy for several days during the spring-pollen season. The participants immersed themselves in a sitting position in Saiboku hot spring water (sodium salt hot spring) at 41°C up to the shoulder level for 10 min in the open-air and then lay on a floor paved with small rocks in a supine position for 20 min in a room filled with the steam from hot springs, then immersed themselves again in the hot spring water for 10 min, and finally rested and sat on a chair for 20 min in a comfortable room. The hot spring water circulated through tubes with small holes that were embedded under the floor, which was paved with small rocks consisting of tourmaline and lime stones. Steam from the hot spring water penetrated through the floor and vaporized in the room. The rock bathing room was 40°C in temperature and 75% in humidity.Results: Clinical symptoms were alleviated in 17 of 19 participants. Watery rhinorrhea, eye itching, sneeze, and sore throat were improved in 100%, 75%, 40%, and 100% of the participants, respectively, compared with symptoms during the previous several years. No adverse effects were observed in any participants. Conclusion: Steam rock bathing, combined with immersion in an open-air hot spring pool, is useful in ameliorating the focal and systemic symptoms of allergic rhinitis.