A program of clinic visits for humanity education has been conducted for 4th-year medical students who have not experienced clinical practices in wards. The major aim is for students to observe the doctor-patient relationship and to establish a close relationship with the tutor doctor. We evaluated the 5-year follow-up data. The most important part of the program was the orientation, which included the aim of the program for students and teachers and contributed to promoting educational effects. A student cannot become a good physician by staying only in the university hospital. An experienced physician who feels a duty to help educate younger doctors may have beneficial effects. In the program, close contact between the students and the tutor had a great effect upon the student which cannot be obtained in the university hospital.

Introduction: Although stop-and-go method is recommended for the introduction of methadone by the Japanese guidelines, it may temporarily result in inadequate pain control and/or serious side effects. We report our experience that alleviation of symptoms was achieved by introducing low-dose methadone at an early stage on top of preceding opioids for a patient with refractory cancer pain. Case: Tapentadol and an analgesic adjuvant were given to a 70-year-old man to treat the patient’s old anal pain due to recurrence of rectal cancer at the rectal anastomosis. However, since the pain was poorly controlled, methadone 5 mg was given adjunctively once daily. After methadone medication, remarkable alleviation of pain and improvement in QOL were observed. Discussion: To achieve a safe pain management, adding a small amount of methadone at an early stage, as in this case, may possibly considered.