There has been a growing concern about the significant shortage of the number of young physician-scientists, who can contribute to the development of basic medicine with the objective of patient-oriented medicine.1-3 This fact holds true of Japan as well as US.1,2 As Armstrong et al. have pointed out,3 early exposure as a medical student or a resident to the challenging clinical cases is crucial for the patient-driven scientific inquiry as to the underlying pathophysiology of the as-yet-unrecognized disorders. In Japan, the establishment of the new medical-internship program and the specialist physician system has made increasingly difficult for young doctors to have enough time to realize the importance of patient-based scientific inquiry. Not a few medical schools in Japan introduced the medical scientist training program also referred to as MD-PhD program, while PhD researchers take the place of physician-scientists in the field of basic research.4 Therefore, it seems to be essential to emphasize the value of the collaboration between PhD scientists with the superior technique in the lab and physician-scientists with the clinical point of view.
[References]
1: Koike S, Ide H, Imamura T. Physician-scientists in Japan: attrition, retention, and implications for the future. Acad Med. 2012;87:662–7.
2: Yamazaki Y, Uka T, Shimizu H, Miyahira A, Sakai T, Marui E. Japanese medical students’ interest in basic sciences: a questionnaire survey of a medical school in Japan. Tohoku J Exp Med. 2013;229:129–36.
3: Armstrong K, Ranganathan R, Fishman M. Toward a Culture of Scientific Inquiry - The Role of Medical Teaching Services. N Engl J Med. 2018;378:1-3.
4: Yaginuma H, Matsumura G, Mori C, et al. Results of a questionnaire on efforts to increase research-oriented doctors. Kaibogaku Zasshi. 2013;88:3-8.
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I am deeply appreciated if you would give me some comments and opinions as to how medical education should be improved in terms of the shortage of the number of young physician-scientists.
Sincerely
Go J. Yoshida MD,PhD.
Hi Go J Yoshida
I can refer you to one of the pioneers of medical education in Iran.
http://en.sme.sbmu.ac.ir/uploads/dean.pdf
I’m sure that based on his experience you might get huge amounts of information in this regard.
Hi Go J Yoshida
It's problem for every developing countries. Medical scientists are required to develop best medicine.But the problem is research activity is not at all part of medicine graduation.If we incorporate such graduate level research subject we can motivate young physicians.Medical profession is now turning around Evidence based medicine.Young physician can understand this importance then they get motivated about research.
My personal opinion is to include moral cultivation, when seeing repeated medical tragedies, immediately looking for alternative medical solutions instead of I encountered many patients who got obvious improvement but not dare to tell their MDs due to their MDs told them that "You cannot visit an acupuncturist!". So, I cannot let them to discuss their drugs with their MDs. I tried to call some of the MDs, I had never got any reply. Those MDs use bias eyesight to look acupuncturists.
Thank you for giving me precious comments.
It is a very important thing to establish the system in which scientific doctors work as a contributor to the basic medicine as well as the clinical settings.
The best medical system also educate students that
1. The health care is for both rich and financial disadvantage system.
2. Do not use patients as your white mouse. Test on self first. If a researcher or the doctor do not want to take the drug or therapy, do not give to the patient. Like MDs prefer natural die without chemotherapy or surgery, why ask cancer patients to do those treatments?
3. Be loyal to the patients. Do not treat patients as their hen to lay golden eggs for them. Like dentists use a machine to clean teeth to make cavities, but blame patients do not well brush their teeth. Kidney dialysis center uses higher concentration sugar to make diabetic patients getting worse.
4. Always looking for a cheaper and better way to treat patients.
Treat patient's root problem instead of letting patients entering organ failure and medical tragedies.
6. Educate and return the health care's primary responsibility to the patients instead of allow they have the wrong attitude that they enjoy abusing their body's stuffs and enjoyments, but, throw their medical cost to the whole society or without paying health care professionals.
7. Keep the medical job as a conscious job not a labor job to only follow routing to avoid trouble without using his heart to treat patients to be better. Like some told me that when patients walk out my treating room, throw them out of my brain. But, I treat many severely sick patients and many mistreated patients and their situations are complicated by drug side effects, wrong concepts, bad habits, do not follow instructions, family/jobs/relationship problems do not know how to handle, poor moral cultivation, etc. Without facing each case to solve or guide the patient to solve, the patient can be forever spending a country's fortunate.
There are more to say. But, if can do the above things, the medical system will not eat up a country's fortunate.
Needs of current kiotic working health system or needs to support a reformed responsive and supportive healthcare system?? That is the question.
I remember Charles Boelen concept of five star doctor which is involved in delivery of health care based on relevance, equity, quality & cost effectiveness besides having attributes of care providers, communicator, decision maker, team leader & health Manager.
It also depends whether our health care delivery is value based reflecting the societal values and culture..
Best Medical education system must discharge its social accountability in partnership with health system & community .
Competency-based, centered in the patient problem is the most efficient medical system today. Of course, with all the conventional methods integrated properly in the system
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