1) We reported recent movement to graduate entry program (GEP) of medical education curriculum in the UK by both interviewing faculty members who are in charge of GEP and doing literature review.
2) In GEP, we may be able to make better doctors in short term.However, as long term outcome is not known so far, further discussion is necessary.
3) Many contents can be improved by just curriculum change, not by introducing GEP.Besides it can be said that GEP can make diverse doctors.

In March 2001, Research and Development Project Committee for Medical Educational Programs proposed a model core curriculum for undergraduate medical education. In this curriculum, implementation of the clinical clerkship is strongly recommended. Two similar curriculum models were later presented by other organizations, and some differences were observed among them. We, Undergraduate Medical Education Committee, have evaluated and compared themodel core curriculum 2001 with the Japanese newer proposals as well as those of USA and UK. Here is reported our proposals for a better rewriting of the learning objectives in the model core curriculum 2001, with some emphasis on the nurture of the competence of the case presentation and decision making process.

In order to implement, or enhance the quality of clinical clerkship, it is necessary to develop good educational environment which will be appropriate to allow medical students participate in medical team services. Important things to be considered will be, (1) Systematic management of the individual department's program by the faculty of medicine, (2) Developing educational competency within the medical care team function, and (3) Nurturing students' awareness forself-diected learning and cooperative team work, and teaching- and medical staffs' awareness of their educational responsibilities. In this paper, to develop better educational environment for clinical clerkship, we propose a desirable situation of the educational organization, dividedly describing on the roles of dean, faculties, board of education, department of medical education, clerkship director, teaching physicians, residents and medical students.

This is a report of the 16th Annual Conference on Student Selection held on August 30, 1997 in Tokyo. The main topic of discussion was the subject whether bachelor's degree must be required to medical school applicants. Advantages, disadvantages and expected future problems concerning the proposal by the advisory committee of the Ministry of Education and Culture are widely discussed.

This is a report of the activities of the committee on medical student selection 1994-1996, particularly focused on the 15th Conference on Medical-Student Admission held 1996/8/31 with the subjects of social needs and influences upon high school education for the purpose of improving student selection system in Japan. We must consider how largely admission tests have being influenced high school students at the time of decision making, what medical schools they submit their applications to, and what ability the society or community requires physicians, for creating better system of evaluation for admission in Japan.

To provide material for a panel discussion entitled “The Image of the Female Physician Desired in the 21st Century” at the 28th Congress of the Japan Society for Medical Education, a survey was conducted on the present circumstances of female physicians practicing in Japan. The questionnaires were sent by mail to all 27, 779 female physicians residing in Japan who could be contacted. The rate of response was 29.5%. The results showed that more than 94% of female physicians currently work at institutions for medical services and that only 3.1% engage in works of basic medical research or work as public health administrators. The results also showed the necessity of providing better systems for the support of family life of female doctors to maintain their activities as precious human resources of society.

We used questionnaires to study the present status of undergraduate clinical training at medical schools in Japan in February 1996. Completed questionnaires were returned by 81%(65) of 80 medical schools and approximately 54%(1, 328 clinical departments) of the schools. The results were as follows. Courses for early clinical exposure in the 1st or 2nd year were provided at 83% of the 65 schools; clinical clerkships in the 5th and 6th years were provided at 28%. Specific behavioral objectives for clinical training were clearly shown to students and teaching staff at 75% of schools. Clinical procedures that medical students were permitted to perform were listed and announced to students and teaching staffs at 66% of schools. Patients were informed and gave consent for clinical training of students at 77% of schools. Essential knowledge and skills of students were assessed before the start of clinical training at 40% of schools, and summative assessment was made at the end of the training at 72%. Training of clinical teaching staff for faculty development was conducted at 51% of schools. Eightynine percent of schools reported a shortage of clinical teaching staff. Similar results were obtained in the survey of clinical departments of university hospitals: most departments complained of a shortage of teaching staff, of students not being active, and of students not being competent to enter clinical training courses. To improve clinical training, the introduction of clinical clerkships and cooperation with community facilities outside universities were the main issues.

A questionnaire survey on clinical procedures performed by medical students on patients during undergraduate clinical training was conducted in february 1996. Responses were received from 1328 clinical departments of university cospitals at 80 medical schools. Basic clinical procedures that medical students were permitted to perform on patients were recommended by a committee of the Ministry of Health and Welfare. These procedures are divided into three categories: level 1; procedures that medical students are permitted to perform under the supervision of an instructor; level 2; procedures medical students are permitted to perform with supervision under certain conditions; and level 3; procedures for which medical students are generally limited to assisting instructors or to attending and observing patients. The status of performance of the procedures was investigated. Of level-1 procedures (36 procedures), 8 were performed by medical students at more than 80 % of university hospitals, 19 were performed at from 50% to 70%, 9 were performed at less than 50%. Of level-2 procedures (15 procedures), 8 were performed at from 55% to 79% of hospitals and 7 were performed at less than 50%. For level-3 procedures (15 procedures), medical students were permitted to assist and observe 4 procedures at from 82% to 86% of hospitals, 11 at from 50% to 79%, and 1 at40%. In addition, students were permitted to perform 13 level-3 procedures at from 10% to 44% of hospitals and to perform 3 at from 6% to 9%. In many clinical departments, other kinds of procedures specific to the departments were adopted. Teaching media, such as standardized patients' computer-assisted instruction models, and animal materials, were used, and facilities in the community cooperated in training. Respondents wrote many suggestions and opinions about the difficulties and concerns with the legality of students' performing clinical procedures, patients' consent or agreement, minimal essentials of clinical competence of students, the shortage of instructors, and the training and guidelines for instructors.

We surveyed in every medical university in Japan on how attitudes development is adopted in its medical educational curriculum so far. There are several universities which in some way have already adopted attitudes development into curriculum or teaching items. However, hours of lesson and the contents are so differed among them. Moreover, both evaluation of these lessons by trainees and judgement as far the educational effect by trainers are not programmed satisfactorily. Some universities complain of manpower shortage, difficulties of fixing curriculum, or shortage of total lesson hours, so that they say they cannot dare work on this attempt. But, there are still an increasing number of universities ready to start their programs, where education arranged by non-medical teachers, practical medical experience at the real front, the introduction of simulated patient (SP) into education, and so on are considerd to be carried out.
Thus, we suppose it is time to have and share some guideline for adequate attitudes development education at this moment. And at the same time, a national system to encourage the medical education, including trainning SP, is urgently required to be planned.

Discussions on the postgraduate medical school and the speciality training course after graduation had been conducted 2 times in 1994 among the members of the working group on postgraduate medical school and speciality training in Japanese Society for Medical Education. Results of the discussion are reported in this paper as a proposal for the improvement of the present state of education and training in the postgraduate medical schools in our country. In this report, several important proposals which need further discussions such as the shortening the clinical course in postgraduate medical school to 3 years from present 4 years and necessity of establishing the obligatory course for training the basic technology for life science research are presented. It is mandatory to have full time teaching staff as well as exclusive space for postgraduate course in each school to improve the of education of postgraduate medical schools.