Postgraduate training and career choices: an analysis of the National Physicians Survey in Japan.
OBJECTIVE
This study analyses and discusses recent changes in young Japanese doctors' career paths, in terms of their distribution in different types of facilities and specialties, following changes to the postgraduate clinical training system in 2004.


METHODS
Data from the National Survey of Physicians, Dentists and Pharmacists conducted by Japan's Ministry of Health, Labour and Welfare were used for this study.


RESULTS
After the introduction of the new postgraduate training system, 2 years of clinical training became mandatory and a doctor-to-facility matching system was introduced. Since then, more young doctors have migrated from academic hospitals to non-academic hospitals. The number of first-year doctors at non-academic hospitals increased, whereas the number at academic hospitals decreased. In terms of the distribution of doctors per specialty, the decreasing tendency of doctors to choose internal medicine and surgery has accelerated. These results illustrate the significant changes that have affected young doctors' career paths since the new system was introduced.


CONCLUSIONS
Designing and providing desirable postgraduate clinical training and achieving appropriate doctor distribution are important policy issues. Appropriate policy interventions regarding a mechanism to ensure the appropriate distribution of doctors should be established and attention should be paid to expanding doctors' choices and increasing patient satisfaction and general cost-effectiveness.
Koike
Soichi
S
Department of Planning, Information and Management, University of Tokyo Hospital, Tokyo 13-8655, Japan. koikes@adm.h.u-tokyo.ac.jp
Ide
Hiroo
H
Yasunaga
Hideo
H
Kodama
Tomoko
T
Matsumoto
Shinya
S
Imamura
Tomoaki
T
D002321:Career Choice; D004503:Education, Medical, Graduate; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D013038:Specialization