1) Open of advertisement of qualified specialists belonging to medical societies that fulfill 9 formal criterions and recognition of the importance of qualified specialists.
2) Significant reduction of clinical training doctors matched to the university hospitals and also predictions of reductions in the number of applicants to the clinical training system for specialists at the university hospitals or clinical course of postgraduate school.
3) University hospitals have not satisfactorily established the system of status and economical indemnification for specialists under clinical training.
4) Concern for reduction of clinical doctors involved to medical research.

In 1996, our medical school introduced symposium-style learning that is focused on recent advances in medical science as a regular undergraduate program for 6th-year students. The goals of this program are as follows: 1) to teach that good scientific research is essential to support high-quality medical education and medical care, 2) to have students enjoy research in a way they cannot in the ordinary curriculum, and 3) to stimulate interest in research in medical students who may become researchers in the future. Although a long-term survey is needed to evaluate the effects of this kind of learning strategy, an analysis of questionnaires showed that it was effective for the intended purposes. Today, the content of medical education has become diversified, and the social demands on medicine have changed greatly. Thus, we believe it is necessary to develop an education program separately from traditional ones that are primarily oriented to transmission of knowledge.

The Ministry of Health and Welfare of Japan is planning a pooling system for multiple-choice questions (MCQs) for the national examination for medical practitioners. To clarify possible problems of such a system, a field study was performed by 10 medical schools in Japan using 90 MCQs from previous examinations. Nine hundred twenty-four 6th-year students participated in the field test. For each MCQ, the correct-response rates at the originating school and those obtained in the field test were significantly correlated. Thus, the correct-response rates to questions on the field test could be predicted from the rates at the originating schools. However, for each question the correct-response rate was significantly higher for students of the originating school than for students of other schools. In the national examination, care should be taken to prevent differences in scores on the basis of question sources.