Medical doctors specializing in internal medicine and surgery are fast disappearing from many rural municipalities. Such a nightmare may be hard to believe, but it is becoming a reality due to a new system for certifying specialist medical doctors that will take effect this spring.

The new system, initiated jointly by the Japanese Medical Specialty Board (JMSB) and the Health, Labor and Welfare Ministry, is causing an increasing number of young and talented doctors to turn away from internal medicine and surgery, and to seek work in ophthalmology and otorhinolaryngology instead. This is because doctors will not get certified as specialists until after they reach the age of 30 and they will be required to work in remote areas before receiving such certifications in internal medicine and surgery. Although the JMSB and the health ministry claim that the new system is aimed at producing skilled specialists, it will in fact ruin Japan's medical services and unless something is done, deprive residents in rural communities of chances to receive proper medical care.

An analysis of data compiled by the JMSB has revealed shocking facts. In the nine prefectures of Akita, Fukui, Kagawa, Tokushima, Tottori, Shimane, Yamaguchi, Kochi and Miyazaki, the number of new doctors specializing in internal medicine will dwindle to 15 or less each during fiscal 2018, which begins in April. Similarly, the 14 prefectures of Aomori, Gunma, Yamagata, Fukui, Yamanashi, Nara, Shimane, Yamaguchi, Tokushima, Ehime, Kagawa, Kochi, Saga and Miyazaki will each have five or less new surgeons. Of them, Gunma, Yamanashi and Kochi will have only one each.