Objective To discuss the treatment and prevention of bile duct complications after living donor liver transplantation. Methods The clinical data of 84 cases of living donor liver trans-plantation including 56 adult recipients and 28 pediatric recipients were analyzed. Amongst the 84 pa-tients, 66 had benign end-stage liver diseases and 18 hepatocellular carcinoma. Duct-to-duct biliary re-construction was performed in 50 cases. One recipient received an end-to-end and end-to-side anasto-mosis of hepatic duct of donor and hepatic duct and common bile duct of recipient and another under-went end-to-end anastomosis of hepatic duct of donor and hepatic duct and cystic duct of recipient while the other 32 cases hepaticojejunostomy. 4Fr or 6Fr stent was routinely inserted into bile duct af-ter biliary reconstruction and elicited from the anterior wall of common bile duct or lateral wall of jeju-nal caecum of recipient in all the 84 cases. Results Twenty-four cases had biliary complications and the incidence was 28.5 %. The incidence of biliary leakage was significantly different between duct-to-duct reconstruction and hepaticojejunostomy (8.3% νs 16.7%, P＜0.05). The incidence of biliary stricture was markedly different between duct-to-duct reconstruction and hepaticojejunostomy (50% νs 16.7%, P＜0.05). The biliary complication was remarkably different between single hepatic duct and multiple hepatic duct (20.8% νs 79.2, P＜0.05). Four cases of biliary leakage were cured with con-servative treatment and the other 4 need reoperation. Four cases of biliary stricture were cured by way of endoscopic dilation and nose-biliary drainage, 2 cases turned to be better. Six cases were cured by conversion of hepaticojejunostomy and 4 turned to be better by way of percutaneous transhepatic biliar-y dilation and drainage. The recipients didn't die of biliary complications. Conclusion It is necessary to decrease the biliary complications after living donor liver transplantation, to be satisfactory blood supply and anastomotic technigue and select appropriato biliary reconstruction.

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.

With the enactment of the amended Anti-Discrimination Act, which mandates the provision of reasonable accommodations, the urgent task for all health professional education institutions is to establish a support system for students with developmental disabilities. On the other hand, they are also required to fulfill their social accountability through quality assurance in education, such as the implementation of outcome-based education curriculum. In order to consider how to balance reasonable accommodations for students with developmental disabilities, quality assurance in education, and social accountability in undergraduate medical education, Professionalism Subcommittee held a workshop on April 22, 2023. The participants engaged in active discussions during the workshop.　Through a post-workshop survey, educational needs and challenges in supporting students with developmental disabilities were clarified, providing insights for future Subcommittee activities.

The Professionalism subcommittee of Japan Society for Medical Education has been examining a diverse range of issues related to medical professionalism education for approximately the past 20 years. In July 2015, the committee formulated and presented a draft on “ The Attributes and Competencies of Physicians: An Exploration of Professionalism” Based on this, we have been conducting educational activities on professionalism education, but we had not documented this draft. We are now re-presenting the draft here with minor lexical corrections and additional notes. The professionalism of physicians is delineated in seven attributes and competencies :1. Sense of mission and responsibility towards society2. Practice of patient-centered health care3. Demonstration of integrity and justice4. Acceptance of diverse values and sharing of fundamental values5. Fulfilling roles as leaders/members in organizations and teams6. Pursuit of excellence and lifelong learning7. Self-management and career developmentThis document is presented with the expectation that it will contribute to future discussions on professionalism education.