Medical Education in 21st century

医学教育是一个长期的过程，医学教育工作者必须考虑未来几年医学教育的效果。21世纪要求医生扮演更广泛的角色，医学教育必须培养有能力承担这些角色的医生。与医学教育有关的一个特殊问题是如何为社会培养最佳的医生人数。1986年，日本厚生福利省内的一个特别委员会审议了这一问题，并建议将医学院的入学人数减少10%。最近，厚生福利部成立了另一个委员会来考虑进一步的削减，我们检查了医学教育项目，医生的数量，发现有很多因素需要考虑，根据不同的假设，未来的预测有很大的不同。我们调查了全球医生劳动力政策的趋势，即使在发达国家也没有达成共识。例如，英国将与德国相反的趋势增加医学院的招生数量，我们也对问卷中的执业医生的工作条件进行了调查，发现现实与理想的情况存在很大差距，如会诊时间、病人数量和工作时间。我们还注意到，未来将更详细地研究医疗保健成本与医生数量之间的关系。

Medical education is a long process and medical educators have to consider effect of medical education for comming years. 21st century requires wider roles for physicians and medical education have to prepare physicians who are capable to assume those roles. One special issue related to medical education is how to prepare optimal numbers of physicians in the society.In Japan in 1986, special committee within the Ministry of Health and Welfare considered this issue and 10% reduction of entering class of medical schools was recommended. Recently agin the Ministry of Health and Welfare established another committee to consider further reduction and we examined medical education programs, numbers of physicians and find out there are many elements to be considered and according to different assumptions future forecast is quite different.We investigated global trend on physician work force policy and there is no consensus even in developed countries. For example U.K.will increase the number of medical schools intake on the contrary of trend of Germany.We also examined the practicing physicians working conditions in questionaires and found out great discrepancy between reality and ideal settings, e.g. consultation time, number of patients and working hours. We also noted there will be more detailed examination of relationship between medical care cost and number of physicians in future.