Worldwide societies are aging fast, demanding more and the rising burden of chronic and behavioural related disease increase pressure on healthcare systems.These healthcare challenges are alongside with the fact that formally Japanese doctors occupy a central role in the daily management of Japanese healthcare, as heads of departments, heads of hospitals in large urban settings or in the country side, and as responsible for thousands of clinics countrywide.This paper presents why we feel management education should be provided in medical education programs for Japanese doctors, how it could be structured and why it is relevant in today's Japanese healthcare.It further discusses some of the contents that ought to be taught, including the critical management area of leadership.We conclude that: i) Physician education in management is relevant as change management skills, leadership and motivation are increasingly called upon by new healthcare challenges;ii) The good aspects of Japanese healthcare need to be maintained and doctors'knowledge of management and leadership can prepare them to better defend and develop them with management and politicians; iii) Management education should be“spiral”, maybe starting with Japanese doctors who are heads of healthcare units possibly with a combination of workshops, residential and online courses.