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

I.关于医学本科生初级保健（PC）课程的全国性调查我们在全国范围内进行了调查，以检查日本医学院校本科生的PC课程。日本所有医学院中有70所（88%）做出了回应。在过去的十年中，在PC领域开设讲座和体验课程的学校数量增加了三倍或更多，但许多医学院校长（超过60%）认识到PC教育的现状应该得到改善。关于日本医学生对PC的兴趣和职业偏好的全国调查我们在全国范围内进行了调查，以了解医学生（1年级，4年级和6年级）对PC的兴趣和职业偏好。对73所医学院校的14468名医学生进行了问卷调查，总有效率为74%。75名受访者回答对PC感兴趣，36%的人对PC有职业偏好。与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、有以前或中间学位。学生对社区综合护理的体验及对社区综合护理必要性的认知采用问卷调查法，对10所医学院6年级学生进行调查。676名学生回答（回答率70%）。有75名学生曾到社区门诊就诊，93%的学生认为所有学生都应该去体验，有课程体验的学生与无课程体验的学生在对社区门诊必要性的认识、对社区门诊护士角色的认识、对转诊的学习、对社区门诊护士角色的认识、对社区去看门诊

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.