Aspects of clinical skills test demanded by the public for the national medical licensure examination in Japan

Dear Sir

Clinical skills tests have recently been added to the national medical licensure examinations in Canada, the US and Korea, and are currently being considered in Japan. As the addition of these costly tests might become a substantial societal burden, obtaining the general public's opinion is essential, as previously shown by a US poll (Papadakis 2004). Moreover, the competencies (i.e. skills in communication, medical interview, physical examination, case presentation, chart writing and clinical procedures) demanded by the general public for inclusion in the clinical skills tests for new doctors remain unknown.

To ascertain public opinion regarding the clinical skills tests, we conducted an Internet-based survey using a 15-item questionnaire among 7213 Japanese (age, 20–69 years). Our questionnaire was based on our previous study (Fukushi et al. 2006). Respondents preferences were rated on a 5-point Likert-type rating scale.

The questionnaire was completed by 3093 people (1531 men, 1562 women; completion rate, 42.9%). Most responders (n = 2800, 90.5%) favoured adding clinical skills tests, particularly including the main skills such as ‘explaining and discussing medical issues clearly and accurately to patients’ (n = 2176, 70.4%), ‘accurately diagnosing problems by physical examination’ (n = 1984, 64.1%) and ‘ability to carefully interview patients to make a diagnosis’ (n = 1663, 53.8%). No significant difference between this preference and the respondent characteristics was found (p > 0.05; Pearson chi-square analysis).

Although the professional licensure examination components should depend on not only public demand but also the decision of medical professionals, the results revealed that the respondents’ priority requirements were basic communication and physical examination skills. Even with the expansion of medical school curricula with advances in medicine, teaching basic interview and physical examination skills is still needed. Medical educators should carefully consider these skills when teaching and assessing medical students.