Attitudes of medical and co-medical students toward congenital anomalies and prenatal diagnosis were investigated. After problem-based learning in medical genetics and embryology, students were shown a short film of a fetus with spina bifida. The students were then asked by questionnaire to answer the following question: “If you were told at 20 weeks' gestation that your fetus had spina bifida, what would you do?” About one third of the female medical students and half of the male students said they would terminate the pregnancy. The students' written comments suggested that female students are more receptive to delivery and to handicapped children. In contrast, male students' attitudes were more passive. Responses of female public health nursing students were similar to those of female medical students, and those of student midwives were much more receptive. These results will provide a basis for education in medical genetics and medical ethics.

1) A person with a medical qualification should be a capable practitioner at the start of their career and capable of adapting to future challenges.
2) Teaching models based on'competence'teach technical accuracy, but do not necessarily prepare students to be capable of making sound clinical judgements or of adapting to new developments.
3) ‘Outcomes’based curricula include technical accuracy and prepare students to make good clinical judgements and to continue to adapt to improve the quality of professional practice and performance.

1) Outcomes have been adopted in preference to competences in medical education because it promotes a higher order of professional capability.
2) New assessment instruments have been introduced to examine a student's capability in both undergraduate and postgraduate phases.
3) The principle of preparing students to be'capable doctors'is international.Leading medical educators around the world are introducing changes to traditional courses to achieve this.

1)In medical education in the United Kingdom, departments of general practice organize the basic training in clinical skills and specialty training in primary care.
2)A clinical clerkship in primary care is a compulsory 5–week subject, as are clerkships in internal medicine, surgery, pediatrics, obstetrics/gynecology, and psychiatry.
3)As a tutorial training system has been established, general practitioners are contributing to medical education as clinical instructors.

1)Leaders of skillslabs at Japanese medical schools are concerned about the future of skillslabs.2)The way skillslabs are presently used in Japan is not in accordance with current evidence on teaching skills.3)We present a stepwise process to bring Japanese skillslabs in line with the standards of 2009.

1) We visited 5 Scottish universities (the Universities of Aberdeen, St Andrews, Dundee, Glasgow, and Edinburgh) to observe and learn about simulated-patient programs and communication-skills training.
2) Each medical school has developed its own approach for using simulated patients in training and for giving feedback to medical students.
3) In Scotland, where all medical schools adhere to“Tomorrow's Doctors”and“the Scottish Doctor Curriculum Outcomes, ”curriculum styles vary greatly, but the differences are celebrated.The simulated-patient programs are integrated into each program in a way unique to each school.

Medical students in Japan often want to do clinical rotations abroad. Preparation for these important clinical experiences is essential to maximize the learning opportunities. Language ability is only one small part of assuring success.1) It is important to consider the hospital where the rotation will take place, the specific rotation, the living arrangements and commuting to the hospital. Preparation before the rotation should include practice in performing and writing a complete patient history and physical examination.2) It is very helpful to have a cell phone while abroad, as well as a credit card. Students must bring a white coat, and it is recommended that they also bring a Japanese textbook in the field they will study.3) While on a clinical rotation, students must be active participants in patient care and in discussions. They must be aggressive about answering questions during ward rounds. Students must be aware of many cultural differences to have good relationships with patients and colleagues.

We experienced three cases of triple shunts (VSD+ASD+PDA) for past ten years. All three cases admittied with cardiac failure and respiratory distress early in the infant period. Ligation of PDA, suture closure of ASD and patch closure of VSD were performed in the two cases. Another case was performed ligation of PDA because of low body weight (1, 700g). Triple shunts were correctly diagnosed in only one case. Another two cases were diagnosed VSD and PDA at operative period. The patient with low body weight was lost at 38 days after operation. Post operative course were uneventfull in the two cases of total repair. Triple shunts should be repaired in the same time. But two staged operations are consider to perform in the low body weight infant and patients with major general pediatric surgical disease.