There is no clear definition of medical professionalism, although it has long been discussed. However, it is inappropriate to be preoccupied with the details of its definition. It is more important to understand the basic concept of medical professionalism: a spirit of professionalism developed to gain the trust of patients and society, and implement education on professionalism.

　In the implementation of education on professionalism, it is important to: consider situation-dependent professionalism, focus on its relationships with society as well as individuals, and take into account the attributes of both professional and profession. Education on professionalism should encourage learners to reflect and establish their own identity as professionals, rather than placing an emphasis on education based on the norms, which are centered on lists of behaviors and competencies.

Uncertainty and complexity remains prevalent throughout the practice of medicine. Primary care physicians often experience uncertainty and complexity in their practice because they encounter the wide variety of patients. Coping with uncertainty and complexity is one of the important competence of a physician, and it is one of the attributes of medical professionalism. Tackling uncertainty and complexity is a strong learning chance for physicians and it makes them grow. Using Cynefin framework and good doctor-patient communication with shared decision making are effective strategies for handling medical uncertainty and complexity.

1）Japanese medical students’ exposure to the pharmaceutical industry was surveyed in 2012 by means of a 15–item questionnaire.
2）Responses were received from 5431 students（1755 in the 4th year, 2222 in the 5th year, and 1454 in the 6th year）. The number of preclinical and clinical students in each year was 1755 and 0, respectively, in the 4th year, 853 and 1,369 in the 5th year, and 53 and 1401 in the 6th year.
3）A total of 20% to 37% of preclinical students and more than 95% of clinical students received small gifts, drug brochures, and box lunches while attending a pharmaceutical product seminar. Approximately 10% of preclinical students and 60% of clinical students received a taxi ticket to attend an educational event. In total, 8% of preclinical students and 40% of clinical students attended a dinner party after these educational events.
4）Therefore, the rate of exposure to the pharmaceutical industry was significantly higher for clinical students than for preclinical students.

The relationship between physicians and drug companies has often been discussed. Maintaining trust by managing conflicts of interest is a requirement of medical professionalism. Maintaining an appropriate relationship is considered important in our medical education society. We conducted this survey to understand physicians' attitudes towards gifts offered by drug companies.1) Questionnaires were distributed to 1200 physicians who registered with an Internet survey company.2) After attending medical conference sponsored by drug companies, almost all physicians received ballpoint pens and note pads, and many physicians received, food, drink, taxi coupons, and booklets about clinical guidelines.3) Compared with young physicians, experienced physicians tend to receive more gifts from drug companies. Physicians who worked at clinics received gifts more frequently than did hospital physicians. Physicians who worked at public hospitals and university hospitals were offered travel and lodging expenses for attending clinical conferences.4) Most physicians received gifts from drug companies. The frequency of receiving such gifts differed with the number of years since graduation and the characteristics of their workplaces.5) The results of this survey are valuable fundamental data for discussing and teaching about the relationship between physicians and drug companies.

　The paper reports a summary of the second session: "Educational strategies: Presentation of cases and SGD + group discussion" of the workshop: "Establishment of a consensus on education on professionalism" . The participants in the session set a goal as a milestone at each of the following stages of professionalism competence, presented educational strategies to accomplish them, and held discussions with each other: (1) Immediately following admission to the university, (2) Junior medical students, (3) Preclinical education, (4) Clinical clerkship, (5) Curriculum for students in multiple school years (for six years) , (6) Clinical training, (7) Life-long education.

Introduction: Although community medicine clerkship has been introduced in many medical universities, no study of students’ learning during the clerkship has been conducted. Also, no evaluation of students’ learning about family and community has been carried out.
Methods: Sapporo Medical University fifth-grade students in the fiscal year 2006 to 2007 experienced two-week community medicine clerkships. They were obliged to record their clerkship experiences on a daily reflection sheet. We analyzed all the reflection sheets to understand what the students learned during their clerkships. We extracted all points considered to be examples of learning from the students’ descriptions, and classified these by content, and we also extracted examples of learning about family and community.
Results: The total number of points with learning content that were extracted was 2243 in 2006, and it was 3193 in 2007. Learning content about family and community averaged 5.2% and 3.7%, respectively, in 2006, and 10.7% and 7.9% in 2007. The total number of points of learning about family and community in 2007 increased significantly in comparison with the number in 2006.
Conclusion: By changing the viewpoint of learning by the introduction of a reflection sheet regarding family and community, even if the experience in community medicine clerkship was the same, students’ learning may have changed substantially. It was considered that the establishment of the framework of reflection was an important step.

1)In the 2008 academic year, we developed a new narrative-based medicine (NBM) curriculum at Sapporo Medical University.
2) The program includes lectures on the concept of NBM, the clinical practice of NBM, and the illness narratives of patients' families, and exercises in narrative competence (significant event analysis, parallel chart, and life story).
3) Although some students had negative attitudes about the program, most students evaluated the course positively. We need to continuously improve the curriculum to develop narrative competence in medical students.

Many medical universities have developed community-medicine clerkships. However, few studies have examined what medical students have actually learned from these clerkships.
1) In 2006 students participated in a 2-week community-medicine clerkship, during which they were required to write about their experiences on a daily reflection sheet.
2) All reflection sheets were collected and analyzed. What students had learned from their clerkships was abstracted from the descriptions on their sheets, and the contents of students' learning were categorized.
3) The total number of abstracted learned items was 2243. The numbers of learned items for the areas of medical knowledge, communication, medical skills, clinical reasoning, clinical management, and patient management were 334, 232, 214, 111, 106, and 102, respectively. Learned items in these areas accounted for 49.0% of the total.
4) The numbers of learned items concerning the community and families were 84 (3.7%) and 117(5.2%), respectively, and were lower than the numbers for other categories.
5) A new strategy must be developed to enhance students' learning about the community and families.

1) Since the 2006 academic year, we have developed a 13-hour course in professionalism for fifth-year medical students at Sapporo Medical University.
2) The course included lectures and small-group discussions on the concept of medical professionalism, the definition of medical professionalism, clinical ethics, legal understanding, and the crisis of community medicine. At the end of the course, the students created their own student physician charter and recited it at the student physician charter ceremony.
3) Seventy-four percent of students evaluated the course positively, 18% pointed out positive and negative aspects of the course, and 8% evaluated the course negatively.

The selection of a primary care career by Japanese medical students is said to be increasing however there are no studies to support this belief.In order to fully understand the alleged increase in the number of medical students choosing primary care we believed that an examination of the factors influencing medical students' decision-making would be helpful.
1) We distributed questionnaires to two hundred ninety eight medical students in 2004 who would graduate in four months from three Japanese medical universities.
2) Questionnaires included demographic factors, career choice, important career choice factors, interest in community medicine, willingness to engage in community medicine, thinking community medicine is useful, and satisfaction with curricula.
3) There were significant associations between a primary care choice and social experience, lifestyle preference, interest in community medicine, willingness to engage in community medicine, and contact with primary care faculty.
4) Using a logistic regression model, lifestyle preference, male gender, social experience before entrance to a medical university and contact with primary care faculty were four significant factors.
5) It might be important to consider those factors in addition to curriculum reform to increase primary care career choice among Japanese medical students.