The education ministry has given the go-ahead for Tohoku Pharmaceutical University in Sendai, Miyagi Prefecture, to open a medical school. Under the government’s policy of controlling the number of practicing physicians, it will be the first medical school to open at a university in the country since 1979.
While the move is billed as a response to the severe shortage of doctors in Tohoku in the wake of the March 2011 Great East Japan Earthquake, care needs to be taken so that opening the new school does not drain the already stretched staffing at hospitals in many parts of the region.
Past efforts to control of the number of doctors have resulted in a severe shortage, with the number of doctors per 1,000 people at 2.4 or about two-thirds of the average in industrialized countries. A bigger problem is the regional disparity in the availability of doctors, with the number in all prefectures of the Tohoku region below the national average. The education ministry has so far responded by increasing the enrollment quota at existing university medical schools, but since the early 1980s it has maintained a policy of not authorizing the creation of new schools.
The decision to open a new school in Tohoku — which the ministry says is an exception to the policy — came in response to a plea by Miyagi Gov. Yoshihiro Murai to cope with the severe shortage of doctors in the region made worse by the 2011 earthquake and tsunami, which resulted in the rise in the number of patients and an exodus of medical staff.
While it may help ease the absolute shortage in the number of doctors in Tohoku, doubts have been raised if it will address the problem of immediate shortages in the region.
It would take at least more than a decade for the graduates of the new school, which Tohoku Pharmaceutical University plans to open in April 2016, to take on full-fledged rolls as doctors in the region’s medical services.
The university also needs to address the problem of students leaving their regions to take jobs in urban areas, instead of working in rural areas. A system needs to be created to encourage graduates from the new school to remain in the region and help to fill its medical needs.
Creation of a new university medical school is believed to require roughly 300 experienced doctors to serve as teaching staff. This has caused concern that the new school could exacerbate the current shortage of doctors if it recruits physicians from local institutions to serve as teachers. Sendai, by far the largest city in Tohoku, already has a concentration of doctors. There are worries that the depletion of medical staff from more rural parts of the region could accelerate.
To facilitate reconstruction of the areas devastated by the 2011 disasters, the government and local authorities should consider other steps to address the current staffing problems at many of the region’s institutions.
The government’s policy on the education of doctors has zigzagged over the past several decades. The number of medical schools increased rapidly in the 1970s in response to the medical needs of the postwar economic growth, but the government reversed the policy in 1982, citing alleged concern over a future glut of doctors.
Then, in 2008, the education ministry started approving increases in enrollment quotas at existing schools. Total enrollment quota at the nation’s 80 medical schools increased by 1,400 from 2007 to around 9,100 this year.
The regional imbalance in the number of doctors remains a serious problem, with many prefectures in eastern Japan — not just Tohoku but areas closer to Tokyo such as Saitama, Chiba and Ibaraki — falling behind the national average in the number of doctors per 1,000 residents. Opening new medical schools in those Kanto prefectures should also be considered.
Severe doctor shortages in certain departments such as emergency medicine, pediatrics, and obstetrics and gynecology also need to be addressed. The government policy on medical education will need constant review amid the changing needs of Japan’s society and future demographic projections.
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