The following is a report on the 20th annual meeting of the Association for Surgical Education (ASE) which was held in Toronto from May 3 through 6, 2000. Because Dr. Masahiro Tanabe (School of Medicine, Chiba University), Dr. Takao Morita (Saitama Medical School), and I were the first Japanese to attend this meeting, I will introduce the activities of the ASE and report on this meeting. The ASE was founded in 1980, and its members represent more than 160 medical schools and institutions throughout the United States and Canada. The president of the ASE from 2000 to 2001 is Dr. Nicholas Lang of the University of Arkansas. The educational clearinghouse is located at the Southern Illinois University School of Medicine. The activities include organizing the annual meeting, publishing Focus on Surgical Education, the quarterly newsletter and official publication of the ASE, and distributing resources for surgical education. The ASE's website is at www.surgicaleducation.com, and its official journal is the American Journal of Surgery. The 20th annual meeting was held at the Four Seasons Hotel, Toronto, under the organization of Dr. Richard Reznick, the president from 1999 to 2000. The meeting consisted of 18 oral and 19 poster presentations, special lectures, workshops, and panel discussions. The importance of education in endoscopic surgery was emphasized in workshops and presentations. We were greatly impressed by the meeting and enjoyed participating in it. The next meeting will be held in Nashville from March 27 through 31, 2001.

The compulsory postgraduate clinical training of two years influence not only surgical board system but also otherspecialist education. The compulsory postgraduate clinical training has aimed to train the character as the doctor at thetime of a basic formation as the doctor, to deepen understanding to the primary care, and to acquire a basic clinical ability.Therefore, the introduction of the professional education is delayed, and the possibility that the board certified timingget behind more than present is high. After compulsory postgraduate clinical training, it is necessary to give thespecialist education in a thick efficient program. Especially, cooperation between a university hospital and affiliated institutesis important in the surgical specialist promotion.

At this university, an overseas component has been included in the elective clinical clerkship program for sixth-year students since 1998. Since that time, 28 students have done short-term clinical clerkships in various foreign countries. This report presents results of a questionnaire survey of students who have done overseas clerkships. The questionnaire comprised 8 items, including the reason for selecting the clerkship location and the contents of the training program. Questionnaires were returned by 68% of students. Most of the 28 students did clerkships in English-speaking countries. The average duration of study was 2.3 months (range, 1 to 3 months). All students were satisfied with their training experience; however, many felt their language skills were insufficient for participating in overseas training programs. In addition, more comprehensive arrangements, including establishing close contact with the receiving institutions and insurance provisions, are needed to maintain and further develop overseas clinical clerkships.

We performed a questionnaire survey of 199 graduates regarding surgical clerkships to help select future clinical trainingmethods for fifth-year medical students. Many of the graduates understood the significance of clerkships, and 70%were able to benefit from their participation in clinical training. They approved of clerkships, but 22% had critical opinions.Clinical instructors were asked to teach with greater enthusiasm, to be easier to talk with, and to have a deeperknowledge of diseases. Graduates who attended very few lectures in the fourth year were less likely to expect clinical instructorsto teach well. Most graduates believed that clinical instructors should have at least 5 years' clinical experience.These results suggest that all faculties should continue to place a greater emphasis on education and that faculty developmentshould be expanded.