Evaluation of a medical school for rural doctors.
BACKGROUND
Jichi Medical School (JMS) is the first and only medical school in Japan that was founded exclusively to graduate/prepare rural doctors.


OBJECTIVE
To evaluate the long-term effect of JMS on the nationwide distribution of doctors.


METHODS
Data from the Japanese population census of 1995 and from the Japanese physician census of 1994 were combined for use in this study. We extracted the JMS graduates from the physician census and compared the distribution of JMS graduates to that of non-JMS graduates. JMS graduates have an obligation to work in rural areas for 9 years after graduation. Therefore, we divided them into those doctors who were either "under rural duty" or "after rural duty."


RESULTS
JMS graduates were more likely than non-JMS physicians to practice in rural municipalities. The percentage of JMS graduates practicing under rural duty in communities meeting at least 1 of 4 possible criteria for being considered rural was 2.7 times greater than the percentage of non-JMS graduates in such communities. The percentage of JMS graduates practicing after rural duty in communities meeting at least 1 rural criterion was 2 times that of non-JMS graduates. The JMS graduates accounted for only 0.7% of all the physicians in Japan. However, they accounted for 4.2%, 1.5%, 1.8%, and 3.0% of the physicians in small population, remote, mountain, and medically underserved municipalities, respectively.


CONCLUSIONS
The goal of JMS to produce rural doctors in Japan has made an impact on doctor distribution nationwide.
Inoue
Kazuo
K
Department of Public Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. inouek@m.u-tokyo.ac.jp
Matsumoto
Masatoshi
M
Sawada
Tsutomu
T
D000328:Adult; D019352:Censuses; D006801:Humans; D007564:Japan; D008507:Medically Underserved Area; D008875:Middle Aged; D011365:Professional Practice Location / Q000706:statistics & numerical data*; D015397:Program Evaluation; D019035:Rural Health Services; D012424:Rural Population; D012577:Schools, Medical / Q000592:standards*; D000078329:Workforce