Japan: Medical Training - Medical Education

Medical Graduates Per 100,000 Population (2017): 6.8
Nursing Graduates Per 100,000 Population (2017): 51.5
Percent Share of Foreign-Trained Doctors (2017): NA%
Percent Share of Foreign-Trained Nurses (2017): NA%

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.
https://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm

“University Fees
“(School of Mediciine, Faculty of Medicine)

“Entrance fee, tuition fee etc.
“Unit: Yen

Item	Upon entry	2^nd year onwards
Enrollment fee	1,000,000	－
Tuition fee	2,500,000	2,500,000
Practical training fee	400,000	400,000
Facilities development fee	1,000,000	1,000,000
Educational enrichment fee	2,500,000	500,000
Total	7,400,000	4,400,000

“The 35 students with the highest scores on the regular entrance examination and the 20 students with the highest scores on the National Center Test for University Admissions (Senta Shiken) are exempted from paying the tuition fee of 2,500,000 yen and the educational enrichment fee of 2,500,000 yen, totaling 5,000,000, for the first year.”

Source: Tokyo Medical University. University Fees: School of Medicine, Faculty of Medicine. From the web at https://www.tokyo-med.ac.jp/english/faculty/graduate/doctor/fees.html, last accessed Feb 5, 2020.

“Government subsidies to national universities have been falling by 1% per year since 2004. Government spending was about 12.4 billion yen in 2004 and declined to about 10.9 billion yen in 2016. Given the Japanese government’s fiscal position, there is little capacity for further funding, and the trend of reduced subsidies is likely to continue. Government subsidies to private universities and colleges were stable over that 12-year period, although the ratio of subsidies to current expenditure decreased to less than 10%. Almost three out of four students attend private universities in Japan.

“Although the increase in tuition fees has been modest in recent years, family disposable income has been decreasing. This has led to a gradual increase in the ratio of tuition fees to family disposable income (Fig. 3). In Japan and other East Asian countries, parents have traditionally been responsible for financing the education of their children. Thus the burden of tuition on families has been increasing, especially for low-income families.

“The household share of higher education expenditure is more than half of the total expenditure on higher education in Japan, and among the most expensive in the world (see OECD, 2015). Public expenditure on tertiary education is among the lowest for OECD countries. Households in Japan already bear a significant burden of higher education costs, but the cost-sharing trend in Japan, as elsewhere, is moving away from public toward private sources.”

Source: Shiro Armstrong, Lorraine Dearden, Masayuki Kobayashi, Nobuko Nagase, Student loans in Japan: Current problems and possible solutions, Economics of Education Review, Volume 71, 2019, Pages 120-134, ISSN 0272-7757, https://doi.org/10.1016/j.econedurev.2018.10.012.
https://www.sciencedirect.com/science/article/pii/S027277571730691X

“Medical training in Japan is an undergraduate course, which involves six years in medical school after graduating from senior high school. Those who pass the national examination then proceed to two years of clinical training, after which they are included in the medical register. In 2017, 8533 students passed the national examinations. Physicians are free to choose where to work, and decisions about where to provide clinical training are made by matching physicians and venues using an algorithm.

“Postgraduate clinical training after medical school became mandatory in 2004, and training facilities for doctors in the initial stages of their career have changed greatly. In 2003, about 70 % of new doctors were trained at university hospitals, and about 40% of them were trained in a single specialist department affiliated with a university. Only a few trainees received more general training from a broader rotation. Since 2004, the number of clinical training hospitals other than university hospitals has grown to comprise more than half of all training facilities.

“In 2015, there were 11 052 clinical training facilities in 1023 hospitals (1410 training programmes), and a total of 8687 newly registered physicians were matched to the training programme (Ministry of Health, Labour and Welfare, 2017o). The number of training slots is far greater than the number of applicants, and trainee physicians are likely to be concentrated in urban areas. Therefore, adjustments such as setting an upper limit on the numbers recruited in individual prefectures have been in operation since 2010 (Ministry of Health, Labour and Welfare, 2017o).”

Source: Sakamoto H, Rahman M, Nomura S, Okamoto E, Koike S, Yasunaga H et al. Japan Health System Review. Vol. 8 No. 1. New Delhi: World Health Organization, Regional Office for South-East Asia, 2018.
http://www.searo.who.int/entity/asia_pacific_observatory/publications/hits/hit_japan/en/
http://www.searo.who.int/entity/asia_pacific_observatory/publications/hits/hit_home/en/#

“The enrolment capacity for medical universities in the 1960s was set at about 3000-4000. In 1973, the Cabinet endorsed a vision of every prefecture having a medical school of its own (Basic Economic and Social Plan, the Cabinet Office). Since then, a number of new medical schools have been established. The enrolment capacity per year reached a peak of 8280 in 1981. In 1986, a special committee of the then Ministry of Health and Welfare recommended that the number of new doctors be reduced by 10% before 1995, in anticipation of a large increase in the number of graduates. As a result, enrolment capacity dropped to 7625 in FY 2003.

“By 2008, however, responding to public and political concerns about the insufficient numbers of physicians, the declining trend was reversed to increase the numbers of medical students again. In FY 2017, the enrolment capacity reached 9420 (Ministry of Education, Culture, Sports, Science and Technology, 2017a). Student enrolment capacity has increased in universities that provide scholarships for those engaging in community health care or set selection criteria, co-operating with other universities to provide the bases for training research physicians and decreasing the number of dental students.”

Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.

Page last updated Dec. 3, 2020 by Doug McVay, Editor.