Residency hospital type and career paths in Japan: An analysis of physician registration cohorts

Abstract

Background: In 2004, a new postgraduate medical training system was introduced in Japan and a shift of new graduates from university hospitals to other postgraduate education hospitals happened.

Aim: The aim of this study is to analyse the past trends on postgraduate medical education choices and subsequent career options to discuss possible outcomes of the current shift and policy implications.

Methods: Data from the national physician survey from 1976 to 2006 were analysed. The proportion change of physicians started their career in university hospitals was calculated. The career paths for physicians by different residency type were presented.

Results: More than 90% of physicians experienced university hospital work at least once in their 20-year careers. In their first 10 years of their career, physicians who started their residency in a university hospital tended to spend more years working in university hospitals, and those who started in other post-graduate training hospitals tended to spend less in university hospitals. Then, these groups presented quite similar patterns in their career choices.

Conclusions: University hospitals need to strengthen their function as continuing education and career development centres and to adopt a less paternalistic approach, as fewer residents start their career in university hospitals.

Additional information

Notes on contributors

Soichi Koike

Soichi Koike is an associate professor in the Department of Planning Information and Management, and manager of Hospital Planning and Management, The University of Tokyo Hospital.

Tomoko Kodama

Tomoko Kodama is the director of the International Health Section, Department of Human Resource Management, National Institute of Public Health of Japan.

Shinya Matsumoto

Shinya Matsumoto is a research fellow, Department of Planning Information and Management, The University of Tokyo Hospital.

Hiroo Ide

Hiroo Ide is an assistant professor, Department of Planning Information and Management and Deputy Director, The Public Relations Center, The University of Tokyo Hospital.

Hideo Yasunaga

Hideo Yasunaga is a project associate professor, Department of Health Management and Policy, Graduate School of Medicine, The University of Tokyo.

Tomoaki Imamura

Tomoaki Imamura is a professor, Department of Public Health, Health Management and Policy, Nara Medical University.