Introduction : While the number of women physicians is increasing in Japan, there is a tendency for these physicians to leave the workforce during their child-rearing years, contributing to an overall physician shortage. In order to create effective policies to ameliorate these shortages, it is important to assess women medical students' views on their careers after marriage and the factors that lead to a low motivation for continuation of their careers..
Methods : From 2010 to 2012, we conducted questionnaire surveys using visual analog scale (VAS) based and multiple choice questions on medical students at the University of Tokushima regarding these issues in women physicians. We analyzed the results of questions included in each of these three-year surveys for women medical students in the first, third and sixth year and men in their sixth year..
Results : VAS results for “intention to continue career after marriage” showed shorter measurements in sixth year women (median 86.5mm, interquartile range (IQR) 64-97mm) compared to sixth year men (median 98mm, IQR 92.5-100mm) (p<0.001). Sixth year women with a VAS of 75mm or under for “intention to continue career” showed less “interest in a medical career” than those with a VAS of 80mm or greater (median 79.5mm (IQR 64.5-88.5) vs. 90.5mm (IQR 82-100)) (p=0.001). All student groups analyzed indicated that a “sense of purpose” was the most important factor in their future careers.
Conclusion : Lower VAS levels for “the intention to continue career after marriage” were related to a lower level for “interest in a medical career” in women medical students, which has implications for education and guidance in the undergraduate years.

Background/Aims: Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood. Methods: This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group). Results: We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%–93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, P= 0.011). Conclusions Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.