The position of primary care in medical education: The situation and the subject for future

一、全国医科本科学生初级保健课程调查我们进行了一项全国调查，以检查日本医科本科学校的初级保健课程。日本70%（88%）的医学院做出了回应。在过去的十年里，开设个人电脑领域讲座和体验项目的学校数量增加了三倍甚至更多，但许多医学院校长（超过60%）认识到个人电脑教育的现状应该得到改善。日本医学生PC兴趣与职业偏好的全国调查我们进行了一项全国性的调查，以考察医学生（一年级、四年级和六年级）对PC的兴趣和职业偏好。共有73所医学院的14468名医学生参与问卷调查，回复率为74%。75%的人回答对PC感兴趣，36%的人表示对PC有职业偏好。与该偏好显著相关的学生特征为：入学时对PC感兴趣、农村背景、女性、父母是临床医生、先前或中级学位。对10所医学院六年级学生进行综合社区护理体验及必要性认知问卷调查。676名学生回答了问题（回复率为70%）。75%的人去过社区的门诊诊所，93%的人认为所有学生都应该体验一下。有过课程体验的学生与未经历过课程体验的学生在与患者在家沟通、门诊护士角色理解、转诊学习、门诊就诊必要性感知上存在显著差异。

I. Nationwide Survey on the Primary Care (PC) Curriculum for Undergraduate Medical StudentsWe conducted a nationwide survey to examine the PC curricula of medical schools for undergraduates in Japan. Seventy (88%) of all medical schools in Japan responded. The number of schools that have lectures and experience programs in the PC field has increased three-fold or more in the past decade, but many medical school presidents (more than 60%) recognize that the present state of PC education should be improved.II. Nationwide Survey on interest in PC and career preference of medical students in JapanWe conducted a nationwide survey to examine interest in PC and career preference of medical students (1st, 4th, and 6th-year). Fourteen thousands and four hundreds sixty-eight medical students in 73 medical schools responded to the questionnaire (respond rate 74%). Seventy-five percents answered being interested in PC and 36% had career preference in PC. Students' characteristics significantly associated with the preference were having been interested in PC at matriculation, rural backgrounds, female, having parent(s) who is (are) physicians in clinic, and having a previous or intercalated degree.III. Students' experience about comprehensive community care and their perception of its necessityQuestionnaire survey was conducted to 6th-year students in 10 medical schools. Six hundreds and seventy-six students responded (respond rate 70%). Seventy-five percents had visited the outpatient clinic in the community and 93% thought all students should experience it. There were significant differences in perception of the necessity between students who had experienced in the curriculum course and who had not about communication with patients in their home, understanding of the role of nurse in outpatient clinic, studying of referring the patients to other physicians, visiting the out-patient clinic.