Since 2003, Clinical training center of Fujita Health University hospital has been cooperated with the Office for medical education of Fujita Health University, school of medicine, in reorganizing the previous training system based mainly on individual departments. After 9 years since then, we established Yanegawara style training system and the trainee–centered curriculums. Outcomes from new system are as follows:
1. Self–establishment by problem based learning became common understandings between trainers and trainees.
2. Teaching by trainers to trainees and between trainees （R2 to R1） became common in the hospital.
3. Trainees can learn the standardized approach in diagnosis and treatment of the patients in ER.
4. Unified understanding of the training system was established in the hospital.Although new system brought several good aspects, we found a large heterogeneity in fulfillment of our curriculums not only by the capability of individual residents but also by the effort induced by each department.

1）To learn the techniques required immediately after the start of clinical practice, new residents were introduced to the skills laboratory during their orientation period.
2）We attempted to establish the Yanegawara style, which is an overlapping teaching style in which the second–year residents plan the entire training schedule and simultaneously teach the first–year residents while being supported in their teaching by more senior physicians.
3）Training with the new system resulted in greater rapport among all residents as well as a greater feeling of security among first–year residents.

1) To our knowledge, medical student abuse has not previously been studied in Japan.
2) In our survey, 68.5% of respondents experienced medical student abuse.
3) Several students reported that they had been frequently neglected or ignored by teaching physicians during clinical clerkships and that such attitudes discouraged them and decreased their motivation.
4) To improve the learning environment, medical educators must take action to resolve this serious issue.