We have an outpatient department and a ward (52 beds) in the department of general internal medicine of the Second Tokyo National Hospital. During the rotation of interns for 8 weeks, interns are taught outpatient management by clinical educators one-on-one basis in the clinic, in addition to inpatient management on the wards, and series of lectures on the general internal medicine, emergency medicine and psychosocial issues. We have a residency program from PGY 3 through PGY 5, which emphasizes outpatient continuous management throughout residency. Our residents present their outpatient cases at the daily outpatient conference that all of us would attend. There are 17 graduates of our residency, many of whom are now clinical educators not only in our hospital but also in the university hospitals and teaching hospitals. Research on the way of training rotation of interns by the national hospitals group suggested superiority of the super-rotate training system of the intern. The residency of general internal medicine would become more important not only for the training of primary care physicians but for the training of clinical educators.

We investigated factors related to the perception of achievement and to the degree of satisfaction of junior residents in initial clinical training. Questionnaires were given to second-year postgraduate students at 13 teaching hospitals in Japan. The response rate was 50%(n=89). The perception of achievement and the degree of satisfaction were converted to a 100-point scale. The mean±standard deviation of the two scores were 70±11 and 68±16, respectively. The average number of inpatients and whether the junior resident had taken care of patients were related to both scores. However, gender, the number of departments rotated through, and salary were not associated with either score.

Cohort Survey at the Beginning of SARS-CoV-2 Vaccination in Japan was planned as an administrative promotion survey project for the purpose of promptly disclosing safety information on SARS-CoV-2 vaccination to the council of the Ministry of Health, Labor and Welfare.The cohort survey of initial series of Pfizer Comirnaty was started on February 17, 2021. In order to conduct the multi-institutional joint research as an observational study in compliance with the ethical guidelines for medical research on human subjects, we used a commercial IRB. We prepared for a research platform including an EDC, research management services, and cooperation with Organization headquarters. Comirnaty was vaccinated on approximately 20,000 healthcare workers over a nine-day period and the first interim report was published on March at the council of the MHLW. Then the cohort survey of initial series of Moderna Spikevax on SDF personnel and AstraZeneca VAXZEVRIA on the general public were started on May and August 2021, respectively. In addition, investigations on the third additional vaccination from December 2021, vaccines for children aged 5-11 years from March 2022, and Takeda/Novavax vaccines from May 2022 and the fourth additional vaccination from May 2022 were not only conducted as safety investigations, but also the changes in antibody titers of some of the subjects were examined. The results have been reported 23 times (as of July 8, 2022) to the council of the MHLW. The database includes specific adverse events such as fever, local pain, fatigue, and headache etc. and MedDRA-coded free-text adverse events, number of sick leave, number of drugs used for adverse reactions, antibody titer trends, and serious adverse events including PMDA reports.

The aim of this study is to report the results of the workshop which was designed to define several indispensable conditions for the implementation of the compulsory clinical training. These conditions discussed include the guarantee of position and improvement of labor conditions for trainees, standard for the authorization of institutions receiving trainees, training curricula and teaching staff of institutions, and the certificate of qualification for the trainees after the compulsory training. The products of the workshop showed plans and guidelines to these conditions as seen in this paper.

The aim of this study is to report and analyze the results of a questionnaire concerning the present programs for the junior residents in the postgraduate clinical course in Japan.
A questionnaire was sent to the administrators or the persons in charge of the programs of 347 institutions including 80 university hospitals and 267 clinical training hospitalsas designated by the Ministry of Health and Welfare.
Answers to a questionnaire were returned by 271 institutions (78.1%). The results were analyzed and summarized as follows.
(1) About 95% of both university and clinical training hospitals have their own programs at present.
(2) In the substantial formula of programs, university hospitals have had straight or rotation form while the clinical hospitals have selected rotation or super rotate (comprehensive) form.
(3) The programs of university hospitals have started in majority before 1992 while those of clinical hospitals have began after 1993.
(4) The programs of university hospitals have contained the clinical training at the other departments or institutions in a significantly higher ratio compared to those of clinical hospitals.
(5) The check system for the evaluation of the programs has well functioned in half of both hospitals.
(6) For the assessment of the programs used, about half of the staffs of both university and clinical hospitals feel unsatisfactorily in their active programs.
(7) Concerning the intention to renewal or modification of their programs used, there were rather passive agreements in both university and clinical hospitals.