Residency hospital type and career paths in Japan: an analysis of physician registration cohorts.
BACKGROUND
In 2004, a new postgraduate medical training system was introduced in Japan and a shift of new graduates from university hospitals to other postgraduate education hospitals happened.


OBJECTIVE
The aim of this study is to analyse the past trends on postgraduate medical education choices and subsequent career options to discuss possible outcomes of the current shift and policy implications.


METHODS
Data from the national physician survey from 1976 to 2006 were analysed. The proportion change of physicians started their career in university hospitals was calculated. The career paths for physicians by different residency type were presented.


RESULTS
More than 90% of physicians experienced university hospital work at least once in their 20-year careers. In their first 10 years of their career, physicians who started their residency in a university hospital tended to spend more years working in university hospitals, and those who started in other post-graduate training hospitals tended to spend less in university hospitals. Then, these groups presented quite similar patterns in their career choices.


CONCLUSIONS
University hospitals need to strengthen their function as continuing education and career development centres and to adopt a less paternalistic approach, as fewer residents start their career in university hospitals.
Koike
Soichi
S
Department of Planning, Information and Management, The University of Tokyo Hospital, Japan. koikes@adm.h.u-tokyo.ac.jp
Kodama
Tomoko
T
Matsumoto
Shinya
S
Ide
Hiroo
H
Yasunaga
Hideo
H
Imamura
Tomoaki
T
D002321:Career Choice; D015331:Cohort Studies; D003625:Data Collection; D004503:Education, Medical, Graduate; D005260:Female; D006761:Hospitals / Q000145:classification*; D006801:Humans; D007396:Internship and Residency; D007564:Japan; D008297:Male