The importance of student participation has been noted, but there is not enough accumulated knowledge on how that “participation” can be achieved. In Kyoto University, a student circle called KS-CoM started a “student-faculty meeting” in 2016 with the objectives of (1) two-way communication between students and faculty and (2) reexamining the nature of pre-graduate medical education. We discussed the handling of past exam questions, grading methods, lectures within the practicum, etc. We tried to clarify both sides’ thoughts on why the education was being provided and how it was being perceived by students and faculty. A “semi-official forum” is needed for students to examine the premise of their education. It will also be effective for establishing partnership-based educational participation.

Background: We investigated how undergraduate medical curriculum handles the question “what is medicine” , which Yonezo Nakagawa raised in a field of study called “Igaku-gairon” .　Method: We analyzed the content, the amount, the methods, the assessment, and the teachers using syllabi that are accessible on the Internet as resources.　Results: In 69 schools, the total number of hours of instruction in “philosophy of medicine and medical ethics” , “sociology of medicine and medical anthropology” and “history of medicine” was 1066 h 20min, 213 h 5min, and 192 h 5min, respectively, representing 72%, 14%, and 13% of the total instruction.　Analysis: We found that their were classes which address the question “what is medicine” without using the word “Igaku-gairon” can be sporadically found in medical curriculum.

We added Kampo medicine (Japanese traditional herbal medicine) to disease-­modifying anti-­rheumatic drugs (DMARDs) to treat rheumatoid arthritis (RA) in 41 patients. After 1 year, disease activity assessments showed improvement in the number of tender joints and DAS 28-­CRP, and Boolean remission increased from 3 cases to 6 cases. However, 16 of 41 patients had an insufficient therapeutic effect with Kampo medicine ; therefore, their DMARD treatment was strengthened. Disease activity in the 16 patients with strengthened DMARD therapy (Western group) was compared with that in the 25 patients who did not require strengthened DMARD therapy (Kampo group). The Western group had high disease activity at the beginning of Kampo medicine, and a year later CRP and DAS 28­-CRP improved. In the Kampo group, disease activity was relatively good at the beginning of Kampo medicine, and patient global assessment (PGA) improved. We believe that combination therapy, with DMARDs controlling synovitis and Kampo medicine improving PGA, is an effective way to achieve Boolean remission.