Factors Encouraging Internal Medicine Specialists in Japan to Move towards Certification as General Practitioners

Factors Encouraging Internal Medicine Specialists in Japan to Move towards Certification as General Practitioners

Takuma Kimura,^1,2 Kyoko Nomura³ and Norio Tanahashi^2,4

¹Department of General Internal Medicine, Saitama Medical University, School of Medicine, Iruma-gun, Saitama, Japan
²Department of Internal Medicine, Maruki Memorial Medical and Social Welfare Center, Iruma-gun, Saitama, Japan
³Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Akita, Japan
⁴Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan

In Japan, a new medical specialist system started in 2018 and has established the “Comprehensive Medical Specialist” program. The Japan Medical Agency allows specially-appointed supervisors, such as specialists in particular branches of internal medicine, to transfer to the “general practitioner” program. These specialists are often considered as reserve general practitioners. In April 2016, we conducted a survey of 2,666 randomly selected specialists in 11 societies related to the Japanese Society of Internal Medicine. Of the 404 who responded (15.2% response rate), 142 (35.1%) were “certification-oriented.” Logistic regression analysis with the outcome of desire for certification as a general practitioner (yes = 1) showed odds of 2.293 (95% confidence interval: 1.379-3.811) for “cannot take the necessary time to prepare” and 12.417 (95% confidence interval: 2.856-53.986) for “should be eligible to take the exam without leaving my current job.” Creating an environment that allows specialists in internal medicine across various specialties to prepare for certification as a general practitioner, while continuing to work in their current positions, would help to increase the number of high-quality general practitioners to supply the need in Japan.

Keywords —— board-certified internists; general practitioner; Japanese Medical Specialty Board; primary care training; specialist to generalist transfer

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Tohoku J. Exp. Med 2023, 259, 335-343.

Takuma Kimura, Department of General Internal Medicine, Saitama Medical University, School of Medicine, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.

e-mail: takumak@saitama-med.ac.jp