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An advisory panel for both the health ministry and the education ministry has proposed abolishing the current training system for medical interns and creating a new one. While the new system, expected to start in fiscal 2010, appears geared more toward securing enough doctors in the countryside, it carries the danger of weakening training quality.

The current system, started in fiscal 2004, gives interns training in a wide range of specialties. In the past, most interns remained at university hospitals and received training solely in their specialty. But the current system is blamed for causing a shortage of doctors in the countryside, as it allows interns to choose where they receive hospital training. A large number of interns have chosen hospitals in urban areas that offer better training and salaries. As a result, the number of interns at university hospitals has dwindled, causing university hospitals to call back doctors dispatched to countryside hospitals.

Under the current system, interns must undergo training in seven designated specialties over 16 months then spend eight more months training in the specialty they have chosen.

Under the new system, also a two-year system, interns, before choosing their specialty, will receive training in internal medicine for six months or longer, emergency medicine for three months or longer and community medical service for one month or longer. They also must choose two of three designated fields — obstetrics- gynecology, pediatrics and psychiatry — for training.

Compared with the current system, the new system may weaken doctors’ ability to take care of different kinds of patients in an emergency. The government also should take effective measures to get interns interested in obstetrics and pediatrics — fields suffering acute doctor shortages.

The new system will impose quotas on the number of interns that individual prefectures and hospitals can take, to avoid a concentration of doctors in urban areas. Quotas for university hospitals will be large. University hospitals will need to provide high-quality and attractive training on a par with ordinary hospitals in urban areas.

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