A questionnaire was mailed to 236 directors of clinical training hospitals and 164 directors of emergency epartments at university hospitals. A 75.4% response rate for clinical training hospitals and a 78.7% response rate for university hospitals was achieved. About 30% of clinical training hospitals and 80% of university hospitals had established emergency departments and an overall 64% of all institutions surveyed were engaged in public education regarding emergency medicine.
From analysis of patients visiting the emergency room at the Kyoto First Red Cross Hospital in 1993, we concluded that a resident has an on-call clinical emergency medicine experience once every one or two weeks in the initial two-years of postgraduate clinical training. This enabled residents to cover most of the proposed subjects as outlined by the Committee of postgraduate clinical training at the Japanese Ministry of Health and Welfare.
We recommend that the initial two-years of all clinical training programs should include an on-call rotation for emergency medicine.