While many hospitals in Japan are certified to train family physician residents, most have limited experience in this training. The training of a family physician to provide primary care requires a unique set of educational experiences compared to the traditional training of other specialists. Family physicians specialize in the breadth of medical care encountered in a primary care setting rather than the depth of care required in a single organ specialty. In addition to training in the family medicine center to develop ambulatory care skills, family physician residents also need to train with other specialists in hospitals and outpatient settings. Specialists of all disciplines have an essential role in training family physician residents, but there is no clear consensus about what family medicine residents should be taught. To maximize the training with other specialists, residents and teaching physicians need rotation-specific educational goals when training with other specialists to realize the expertise needed for the full spectrum of family medicine.

Family medicine is a linchpin of most successful health systems in the industrialized world, and is increasingly being seen as crucial in the current distressed financial climate. Japan has not had a robust family medicine infrastructure, but recently has begun to develop family medicine in several locations around the country. However, few of these programs are adequately training the type of family physicians Japan needs. This article discusses the background of what family medicine entails, an example of what a successful family medicine university program can do, and the potential benefits to Japan in adopting true family medicine.

In "osmotic learning" a student passively observes and presumably absorbs clinical knowledge. Unfortunately, clinical teaching based on this style tends to result in low student motivation to study, which leads to low faculty motivation to teach. Here we consider how to improve medical education in Japan based on a case study of a Japanese student's (H.I.) participatory experience with the adult learning model in the United States. 1) A Japanese medical student analyzed the weekly evolution of her responsibilities and contributions to patient care during a 1 month clinical rotation at the University of Michigan. 2) She participated through direct contact with 235 patients during the 1 month rotation. Starting with simple contributions to patient care, over time she became an active member of the treatment team. Due to the ever-increasing relationship of trust built during the rotation, the faculty member could give the student tasks requiring more responsibility. This led to a relative reduction in the faculty member's workload and, in turn, increased teaching efficiency.3) From this case study, we conclude that clinical education based on the adult learning model can be applied in Japan, where "osmotic learning" has been prevalent, and that it can increase the motivation of medical students to learn and faculty to teach.

Family medicine is a relatively new and rapidly growing discipline in Japan. Nevertheless, for family medicine to achieve recognition as a unique medical discipline in Japan, family medicine must develop its own research agenda and appropriate research methods. However, existing literature in Japanese for guiding the design of family medicine research is scarce. This paper introduces strategies for identifying research questions that emerge from clinical “stories” and connects them with appropriate research designs. This paper provides examples of major categories of research designs including those using a single method and mixed-methods designs that take advantage of the strengths of both qualitative and quantitative methods. A solid research foundation in family medicine needs to be established that preserves the unique attributes of this generalist discipline. Family medicine researchers are needed who can lead research teams to address the complex research questions emanating from primary care clinical practice.