title: Follow-up study of the regional quota system of Japanese medical schools and prefecture scholarship programmes: a study protocol.
abstract: BACKGROUND
  Given the shortage of physicians, particularly in rural areas, the Japanese government has rapidly expanded the number of medical school students by adding chiikiwaku (regional quotas) since 2008. Quota entrants now account for 17% of all medical school entrants. Quota entrants are usually local high school graduates who receive a scholarship from the prefecture government. In exchange, they temporarily practise in that prefecture, including its rural areas, after graduation. Many prefectures also have scholarship programmes for non-quota students in exchange for postgraduate in-prefecture practice. The objective of this cohort study, conducted by the Japanese Council for Community-based Medical Education, is to evaluate the outcomes of the quota admission system and prefecture scholarship programmes nationwide.
  
  
  METHODS
  There are 3 groups of study participants: quota without scholarship, quota with scholarship and non-quota with scholarship. Under the support of government ministries and the Association of Japan Medical Colleges, and participation of all prefectures and medical schools, passing rate of the National Physician License Examination, scholarship buy-out rate, geographic distribution and specialties distribution of each group are analysed. Participants who voluntarily participated are followed by linking their baseline information to data in the government's biennial Physician Census. Results to date have shown that, despite medical schools' concerns about academic quality, the passing rate of the National Physician License Examination in each group was higher than that of all medical school graduates.
  
  
  BACKGROUND
  The Ethics Committee for Epidemiological Research of Hiroshima University and the Research Ethics Committee of Nagasaki University Graduate School of Biomedical Sciences permitted this study. No individually identifiable results will be presented in conferences or published in journals. The aggregated results will be reported to concerned government ministries, associations, prefectures and medical schools as data for future policy planning.
authors.affiliation: Department of Community-Based Medical System, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Community-Based Medical System, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Takeuchi
authors.affiliation: Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Tanaka
authors.affiliation: Department of General Internal Medicine, Hiroshima University Hospital and Graduate School of Biomedical & Health Sciences, Hiroshima, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Tazuma
authors.affiliation: Department of Community Medicine, Chiba Medical Center, Teikyo University School of Medicine, Chiba, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Education Center for Doctors in Remote Islands and Rural Areas, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan.
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Owaki
authors.affiliation: Department of Community Medicine, Niigata University Graduate School of Medical & Dental Sciences, Niigata, Japan.
authors.forename: Seitaro
authors.initials: S
authors.lastname: Iguchi
authors.affiliation: Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Maeda
mesh_terms: D000124:Achievement; D015331:Cohort Studies; D004501:Education, Medical; D004521:Educational Measurement; D004522:Educational Status; D005257:Fellowships and Scholarships; D005500:Follow-Up Studies; D006076:Government; D006801:Humans; D007564:Japan; D008004:Licensure; D010820:Physicians / Q000592:standards* / Q000600:supply & distribution; D011365:Professional Practice Location; D019035:Rural Health Services; D012424:Rural Population; D012570:School Admission Criteria; D012577:Schools, Medical; D013337:Students, Medical; D000078329:Workforce
keywords: Japan; MEDICAL EDUCATION & TRAINING; geography; physicians