The 18th term Ethics & Professionalism Committee started to visualize the final outcome of medical professionalism education in FY 2014. Contributions from 7 small groups in the workshop organized by the committee, accumulated knowledge on professionalism , and the outcome in career development education proposed by the Women Physician Career Education Committee were combined to produce the first draft. Public opinions were invited, and a consensus meeting was held to revise it. This draft consists of 7 sub-domains of medical professionalism:

　1. Relationship with patients and ordinary citizens

　2. Commitment to societal mission

　3. Morality expected of physicians

　4. Accepting various values and consideration of fairness

　5. Role as leaders/members of organizations and teams

　6. Pursuit of excellence and continuing professional development

　7. Self-control and career development

Further revision through society-wide discussion will be continued.

　Bushido is the so-called identity of the people of Japan, which was "invented" during the "official nationalism" movement in the Meiji era when the state of Japan pursued a policy of increasing wealth and military power. After the defeat of the second world war, nationalistic Bushido almost disappeared, while Nitobe's Bushido has been revived after a long absence. However, Nitobe's Bushido was originally described in English to explain peculiar conduct by samurai worriers, such as hara-kiri (self-immolation by disembowelment) and kataki-uchi (redress) .

　Descriptions of Bushido were written mostly in the Meiji Era as a professional code for the worrier class of samurai. Nitobe's Bushido is one of them, in which he focused heavily on Care/harm, Fairness/cheating, Loyalty/betrayal, and Authority/subversion among the moral intuitions of human beings. On the other hand, Care/harm, Fairness/cheating, and Liberty/oppression are the moral intuitions expected of physicians. This difference is large enough to potentially lead to serious ethical misconduct if physicians act the under Bushido code of professional ethics.

Significant event analysis (SEA) is a method of reflecting on the cause of things in a semi-structural manner and utilizing the analysis in the planning of subsequent improvement measures. SEA can be applied to a wide variety of events. In the field of medicine, it is widely used as a tool for promoting patient safety by medical teams in nations such as the United Kingdom. In Japan, the subjects of SEA mainly reflect on their own behavior (reflection) to learn from their experience. Unlike the results of observations done by third parties, the results of self-reflection cannot be denie by the subjects. Therefore, this method is particularly suitable for events in which the actor has been greatly moved emotionally.　The first paper presents an individual SEA method that utilizes individual reflection to improve behavior, the second paper introduces a group SEA method to share lessons learned from individual reflections.

Professionalism is the (right) way of being/doing things as a member of a particular profession. Evaluating legitimacy (right/wrong) of one’s behavior or the behavior of others is a moral judgement. Thus, professionalism is a set of desirable moral characteristics of a particular profession. The education of professionalism firstly promotes learning a set of desirable moral characteristics required in a profession. Secondly, it promotes the resolution of conflict with someone who has different moral characteristics. In this article, a possible learning strategy to promote these learning objectives will be explained based on the emerging knowledge of the science of human morality.

1)Professionalism should be explicitly introduced as a fundamental content into curricula/programs of undergraduate medical education, postgraduate clinical training, and of continuing medical education provided by professional societies and the Japan Medical Association.
2)We need to enhance our research activities on goals and objectives which should be accomplished through professionalism education, effective learning strategies, appropriate assessment methods, as well as the impact of informal and hidden curricula.
3)We propose that the medical profession should collaboratively develop various activities to win the trust of the general society in tandem with the introduction of professionalism education.

1)Continuing medical education (CME) systems were researched in 10 countries. In all countries but one CME is mandatory. Only Spain has voluntary CME, as does Japan.
2)The traditional CME systems in many countries were changed after 2000. We believe this change reflects a global revolution associated with a new wave of medical risk management.
3)To provide better medical services, we must keep improving Japan's CME system. Such improvement is an important responsibility to society.

BACKGROUND : This survey examined how a physician's specialty may influence attitudes towards blood glucose control in diabetic patients.
METHODS : A questionnaire was mailed to all members of the Ishikawa Medical Association (n=1,610) as well as diabetic specialists (n=36) querying their specialties, confidence in offering diabetic treatment, and treatment goals/change levels of plasma glucose levels for 5 theoretical cases.
RESULTS : 301 physicians responded. The percentage answering treatment goal/change levels was 93% of internal medicine physicians (n=145), 72% of surgeons (n=29), 52% of pediatricians (n=23) and 20% in other specialties (n=99). The percentage answering “I am confident in offering diabetic treatment” was 57% of internal medicine physicians, 14% of surgeons, 13% of pediatricians and 3% in other specialties. There were significant differences among specialties in the fasting plasma glucose levels in the treatment goal, and the postprandial plasma glucose change levels. Internal medicine specialists tended to give higher glucose levels than other specialties.
CONCLUSIONS : The majority of physicians interested in diabetes care appear to be internal medicine specialists. Physician's specialty may influence their attitude toward glucose control in diabetic patients.

Aberrations on the short arm of chromosome 8 (8p) are frequently observed in several human cancers. In this study, 20 squamous cell carcinoma (SCC) specimens from the tongue were examined in order to evaluate the role of 8p in SCC of the tongue. Microsatellite analysis using 14 markers demonstrated two commonly deleted regions (CDRs) on 8p. Reverse transcription-polymerase chain reaction (RT-PCR) revealed frequent down-regulation of the FEZ1 gene, mapped to 8p22, and frequent over-expression of the cathepsin B gene, mapped to 8p-21-22. These results suggested that genetic aberrations are involved in the development of SCC of the tongue. However, no significant relationship was observed to be established between the genetic alterations and clinicopathological features. Thus, further investigation is necessary in order to clarify the clinical role of 8p in carcinoma of the tongue.
Arm ; Carcinoma, Squamous Cell ; Cathepsin B ; Chromosomes, Human, Pair 8 ; Down-Regulation ; Humans ; Loss of Heterozygosity ; Microsatellite Repeats ; Tongue

In the revised Core Curriculum, professionalism is listed as one of the basic qualities and abilities required of physicians. The definition of professionalism and related learning objectives (1. trust, 2. compassion, 3. liberal arts, and 4. bioethics) are also presented. However, the Core Curriculum does not explain why these objectives were listed. Therefore, some of them are difficult to understand or differ from what has been discussed in previous meetings of the current subcommittee (and previous committees). To properly and effectively advance professionalism education, it is necessary to confirm the contents of the revised Core Curriculum that are insufficient or inappropriate. It is also necessary to deepen the discussion for the next revision of the Core Curriculum. A symposium was held for this purpose. The main points of each lecture are presented within this report.