This report provides information on curriculum in the medical humanities in Japanese medical schools. We sent a questionnaire to the same eighty medical schools in 1988 for the first survey, and again in 1994 for the second survey.
Seventy-eight medical schools (98%) responded in the first survey, and all eighty medical schools (100%) responded in the second survey. A curriculum in medical humanities was offered at 67 medical schools (86%) in the 1st survey, and at 71 medical schools (89%) in the 2nd survey. Courses in medical humanities were required subjects in 63 medical schools (91%) in the 1st survey, and in 62 medical schools (87%) in the 2nd survey. These courses were taught in the 1st grade at 47 % of schools in the 1st survey and at 60% of schools in the 2nd survey. Total teaching time was 30hours in 33% of schools in the 1st survey and in 36% of schools in the 2nd survey. Subjects included in the medical humanities course included death, communication between doctors and patients, the bioethics of birth, organ transplantation, the history of medicine, and early exposure in the hospital. According to our survey the teaching of medical humanities has become popular at the new national medical schools. At present, it is one of the most important courses in medical education.

Although the Ministery of Health and Welfare, Japan, has an intention to revamp the medical care delivery system, the majority of physicians are currently practicing in the context of some sort of public medical insurance system. Therefore, it is madatory that medical students and young physicians understand public medical insurance system and economical issues to practice medicine in a cost-effective way. We propose here neurosurgical cases used for that purpose employing problem-based learning method in tutorial system.