Cognitive apprenticeship and reflective practice are fundamental educational theories supporting postgraduate clinical training. Community hospital rotations provide ideal opportunities to apply these theories. However, community hospitals face challenges in securing educational time due to faculty shortages and heavy clinical workloads, leading to on-the-job training becoming the primary educational approach. Consequently, opportunities for structured instruction and reflection may be limited, potentially hindering the implementation of cognitive apprenticeship and reflective practice. To address this mismatch between educational needs and available resources, we implemented a remote educational conference focused on clinical questions (CQs) arising from residents' clinical experiences. Unlike traditional clinical conferences that focus on determining patient management, this initiative centers on reflective dialogue based on CQs formulated by residents themselves. By integrating experiential learning theory and reflective practice theory and focusing specifically on the latter three steps of cognitive apprenticeship, we successfully constructed an effective educational model for remote learning environments. This practice enables high-quality medical education that transcends geographical constraints and is considered valuable for future community-based medical education.

The growing prevalence of outpatient chemotherapy highlights the vital role that community pharmacists have in patient care. An online interaction meeting was held annually over a three-year period that aimed to foster mutual understanding between patients with cancer and community pharmacists. Each session involved six pharmacists and seven to eight cancer patients, with the same pharmacists participating each year. These meetings highlighted the potential of community pharmacists to reduce patient anxiety and provide treatment guidance, underscoring the importance of connecting patients with pharmacists.

Sports medicine requires a multidisciplinary and comprehensive approach, making it highly compatible with primary care. Internationally, there are many primary care physicians in the field of sports medicine; however, there are few in Japan. Although the demand for learning about sports medicine is high, there are few facilities where primary care physicians can undergo training. This report discusses the initiatives and prospects of the Kameda Family Clinic Tateyama Primary Care Sports Medicine Fellowship Program, which was established in 2009 and revised and implemented in 2022.

A 73-year-old man, who underwent total esophagectomy and gastric tube reconstruction via the retrosternal route for esophageal cancer 10 years eariler, was referred to our hospital with chest pain. He was suspected of acute coronary syndrome, and coronary artery angiography was performed, showing in-stent restenosis of the proximal site of the right coronary artery, diagnosed as the culprit lesion, and drug-coated ballooning was performed. His symptoms improved, however, the poor expansion of the stent and in-stent stenosis remained, and he was referred to our department for coronary artery bypass surgery. Because the gastric tube was reconstructed just below the sternum and performing sternotomy seemed to be difficult, a left mini-thoracotomy approach using great saphenous vein was planned. Under general anesthesia, an approximately 10-cm skin incision was made on the left fifth rib from the anterior axillary to the midclavicular line, and the chest wall was opened at the fifth and third intercostal spaces from the same skin incision, to secure views of the AV node branch and ascending aorta. First, the great saphenous vein was anastomosed to the ascending aorta from the third intercostal space, using 3.8 mm puncher and Heartstring III (Getinge, Lindholmspiren, Sweden). After that, the graft was guided extrapericardially via the left intrathoracic cavity, and was anastomosed to the AV nodal branch from the fifth intercostal space. The graft blood flow was 48 ml/min. The postoperative course was uneventful and contrast-enhanced CT confirmed the patency of the graft.

Sports medicine requires a multidisciplinary and comprehensive approach, making it highly compatible with primary care. Internationally, there are many primary care physicians in the field of sports medicine; however, there are few in Japan. Although the demand for learning about sports medicine is high, there are few facilities where primary care physicians can undergo training. This report discusses the initiatives and prospects of the Kameda Family Clinic Tateyama Primary Care Sports Medicine Fellowship Program, which was established in 2009 and revised and implemented in 2022.

The role of academic journals evolves with the times. Academic publishing is diversifying, shifting from traditional paper-based formats to broader dissemination through open access. In response to these developments-and to contribute to ongoing progress in medical education-Medical Education (Japan) has undertaken a comprehensive revision of its submission guidelines. As of January 17, 2025, all submissions, peer reviews, and editorial processes are being conducted in accordance with the updated guidelines.　The Editorial Board convened a round-table discussion to explore recent developments, beginning with the revision of the submission guidelines. This discussion elaborates on the journal's role and its relevance to the academic community, including society members, authors, and readers. It features statements from participating editorial committee members and highlights the key issues discussed, including the criteria each member uses to evaluate manuscripts. The aim is to offer insight into the journal's editorial stance and decision-making process.