Release date: 2024.08.27
Becoming a doctor is generally a long and challenging process, and we will outline the process from admission to medical school to postgraduate training and building a career as a specialist.
To become a doctor, you must first enter a medical school at a university. Entrance exams to medical schools are highly competitive, and require excellent academic performance. Tuition for medical school is 3.5 to 3.6 million yen for six years at a national or public university, but private universities can be as expensive as 18 million yen at the lowest and as high as 40 million yen at the highest.
After enrollment, students must complete a six-year course. In the first four years, in addition to liberal arts education, students systematically learn preparatory education in biology and chemistry, which are necessary for medical education, basic medical sciences such as anatomy, physiology, pathology, and pharmacology, and clinical medicine by organ. This knowledge will become the foundation for future medical practice.
Clinical training begins in the last two years of medical school. Passing the common examination (CBT/OSCE) is a requirement for participating in the clinical training conducted in the fifth and sixth years. The common examination determines whether or not students have the knowledge, skills, and attitude required for the clinical training.
During clinical training, students learn the basics of a doctor's professional knowledge, skills, and attitudes while sharing clinical duties as a member of a medical team. After clinical training, students are given an exam to assess whether they have reached a level where they can begin clinical training after graduation.
After graduation, students must pass the National Medical Licensing Examination. This exam comprehensively tests all the knowledge learned at medical school and is held once a year, usually in early February, with the results announced in mid-March. The pass rate is usually around 90%.
After passing the exam and obtaining a medical license, you will work in a hospital as a medical intern for two years. In principle, your training location will be decided through a physician clinical training matching system. Clinical interns are required to devote themselves to their training and are prohibited from working part-time. During your time as a medical intern, you will rotate through various medical departments, such as internal medicine, surgery, and obstetrics and gynecology, to solidify your foundation as a doctor.
Doctors are divided into various specialties, and each field requires specialized knowledge and skills. Representative fields include internists (who treat all types of adult illnesses), surgeons (who treat illnesses and injuries through surgery), pediatricians (who specialize in managing children's health and treating illnesses), obstetricians-gynecologists (who deal with pregnancy, childbirth, and women's diseases), and psychiatrists (who diagnose and treat mental illnesses). Among internists, there are further specialized fields such as cardiologists, gastroenterologists, and respiratory physicians. In order to qualify as a specialist in each field, after obtaining a medical license, you need to undergo additional specialized training and practical experience for about 3 to 5 years. In addition, passing a specialist examination will recognize your high level of expertise in that field.
There are many different career paths for doctors. Some doctors treat patients directly as clinicians in hospitals and clinics, while others engage in medical research and contribute to the development of new treatments and drugs. Some doctors also work in government agencies and are involved in formulating medical policies and improving public health. Still others work in educational institutions, where they teach medical science to train future doctors. Each of these career paths has its own characteristics, and there are many different paths you can choose based on your interests and aptitudes.
Task shifting/sharing is becoming more common in the medical field and is accelerating with the work style reforms for doctors taking effect in April 2024.
Task shifting is an initiative that aims to reduce the burden on doctors and provide high-quality medical care to more patients by delegating some of the tasks that doctors used to perform to other medical professionals. The use of "specialized nurses" who have completed training in specific procedures and can perform some medical procedures under instructions from doctors is also expected to reduce the burden on doctors. For example, by taking on some of the tasks that doctors used to perform, such as changing the settings of artificial ventilators and deciding on the administration of some medications, doctors can focus on more specialized medical care. The role of pharmacists has also expanded, and they can now adjust medications based on prescriptions and provide more detailed medication instructions to patients. This reduces the burden on doctors while improving the safety and effectiveness of drug therapy.
Regarding task sharing, multi-professional collaboration has been further strengthened, and a system has been established in which multiple medical professionals, including doctors, work together to treat patients. Furthermore, the use of ICT allows information to be shared between specialties in real time, enabling more effective and prompt medical care to be provided.
In recent years, the multiple attending physician system has also been attracting attention. This is a system in which multiple specialists work together to treat a patient depending on their condition. With the standardization of electronic medical record systems and strengthened data sharing between medical institutions, the implementation of the multiple attending physician system has become smoother. For example, in the case of a diabetic patient, internists, ophthalmologists, nephrologists, cardiologists, etc. can share patient information on the cloud and work together in real time to decide on a treatment plan.
Furthermore, with the introduction of AI technology, systems are being put into practical use that integrate diagnostic results and treatment plans from multiple specialists to propose optimal treatment policies, making it possible to provide more precise medical care tailored to the condition of each individual patient.
The multiple attending physician system is not just about multiple doctors being involved, but has developed into a comprehensive care system that also includes collaboration between multiple professions, such as nurses, pharmacists, nutritionists, and rehabilitation staff, including physical therapists. This makes it possible to view a patient's condition from multiple angles and provide holistic medical care that not only provides physical treatment, but also includes mental and social aspects.
Doctors play an important role in protecting the health of patients by utilizing their advanced knowledge and skills. However, the environment surrounding the medical field is constantly changing, and the roles expected of doctors are also changing. In addition, the medical system is also continuing to evolve, with the introduction of task shifting/sharing and multiple attending physician systems. In order to provide patients with safe and secure medical care of higher quality, doctors are required to work together with other medical professionals as part of a medical team.
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