일본에 새로운 의과대학 도입하기(Ann Acad Med Singapore, 2008)

일본에 새로운 의과대학 도입하기(Ann Acad Med Singapore, 2008)

Introducing a New Medical School System into Japan

Yasuharu Tokuda,1MD, MPH, Shigeaki Hinohara,1MD, Tsuguya Fukui,1MD, MPH

일본의 대입

Admission to Universities in Japan

입학시험에서의 점수가 대입에 가장 중요하다. 고등학교 성적, 교사 추천서, 교외활동, 봉사활동, 인성 등은 입학과정에 그렇게 중요하지 않다.

Performance in the entrance examination is the key determinant to university admission. Other criteria, such as high school grades, teachers’ recommendations, extracurricular activities, community services and personal character, are usually not considered as important in the admission process.2

최근 입학시험 준비의 강도가 심각하게 높아졌다.

Recently, the intensity of preparation for entrance examinations has severely escalated.

그러나 사회경제적 불균형이 높아지면서, 그리고 일본 내 "working poor"에 해당하는 인구가 많아지면서, 고등교육에 있어서 불평등하고 불균등한 기회에 대한 문제가 제기되고 있다.

However, as socioeconomic disparity increases, with a growing subpopulation of the “working poor” in Japan,4 there is growing concern regarding the unequal and unfair opportunities for children or young persons to pursue higher education.

일본의 의과대학 

Undergraduate Medical Schools of Japan

현재 79개의 의과대학이 있으며, 50개는 국립/도립이며, 29개는 사림이다. 의학교육은 6년이며 보통 2년의 교양, 2년의 전임상, 2년의 임상교육으로 이뤄진다. 대부분의 의과대학생은 고등학교 졸업 후 바로 의대에 들어간 학생들이며, 대학졸업자도 36개 학교에서는 선발하고 있지만 전체의 10% 미만이다. 기초과학에서 연구자를 선발하는 것이 더 어린 학생들을 뽑는 이유이다. 또한 6년제 교육과정이 4년제 교육과정보다 더 이득이 된다.

There are currently 79 undergraduate medical schools in Japan, including 50 national/prefectural ones and 29 private schools.5 The medical education is 6 years in duration, typically comprising 2 years of general liberal arts, 2 years of pre-clinical education and 2 years of clinical education. Most medical students in Japan are immediate graduates from high schools. Although college graduates are also offered admission in 36 schools, they account for fewer than 10% of the available positions.5 Recruiting researchers from the basic sciences may be one reason for admitting younger students (18 years old) to medical schools in Japan. Furthermore, a 6-year curriculum is more profitable for universities compared with a 4-year one.

의과대학 입학

Entering Undergraduate Medical Schools

여러 단과대학 중 의과대학 입학이 가장 어렵다. 

Among all the departments in the universities, entry to undergraduate medical school is the most difficult yet the most prestigious.6 Thus, Japanese students who aspire to enter into medical schools prepare arduously for the entrance examinations.

고등학생은 1학년을 마치고 먼저 이과(Rikei) 혹은 문과(Bunkei)를 선택한다. 이과는 고등학교 수학을 3년간 하고 문과는 추가적인 수학교육을 받지 않는다. 대부분의 일본 의대생은 이과출신이며 문과에서는 거의 입학하지 않는다. 따라서 의과대학의 입학시험은 주로 이과 과목을 중심으로 하며, 따라서 문과출신 학생은 거의 들어오는 것이 불가능하다.

High school students must choose either the Mathematics/ Physicochemical Science (Rikei) or Humanities/Social Science track (Bunkei) after completing their first year of high school. Rikei students take 3 years of high school mathematics, whereas Bunkei students are not required to study any additional mathematics.7 Most medical students in Japan come from the Mathematics/Physicochemical Science track and not from the Humanities/Social Science track,6 as the entrance examinations of medical school are traditionally based on the content of the Mathematics/ Physicochemical Science track. Thus, very few students from the Humanities/Social Science track are able to enter into medical schools in Japan.

프로페셔널리즘, 휴머니즘, 윤리교육

Professionalism, Humanism and Ethics Education for Medical Students

그러나 프로페셔널리즘, 휴머니즘, 윤리에 관한 문제는 의대생과 젊은 의사들 사이에 최근 심각한 이슈가 되고 있으며, 의학교육자와 대중의 관심도 몰리고 있다. 프로페셔널리즘에 어긋나는 행동을 한 일부 학생들도 실제로 의과대학에 입학하곤 한다. 성격이나 인성이 의과대학기간동안 형성되기는 어려우며, 일부 학생들은 프로페셔널리즘, 휴머니즘, 윤리를 배우고자 하는 의지가 부족하고 이는 사회경험이 적거나 엘리트주의에 빠져있기 때문으로 보인다.

However, issues in professionalism, humanism and ethical behaviour among medical students and young physicians have recently become a widespread serious concern to medical educators and the general public in Japan.12,13 Some students with unprofessional attitudes and behaviours are indeed allowed to enter into medical schools.12,14,15 Formation of character and promotion of virtue may be difficult during the medical education period, as some students are poorly motivated to learn professionalism, humanism and ethics because of a lack of social experience, as well as an exaggerated perception of elitism.

일본 의과대학 입학 개선

Reforming the Admission Criteria to Medical Schools in Japan

많은 문과 학생 중에도 미래에 좋은 의사가 될 사람이 많을 수 있고 환자와 의사소통을 잘 할 수 있다. 처음에는 생화학, 분자생물학, 생물통계학 등을 배우기 어려워 할지도 모르지만, 이 과목들이 대부분 어려운 수학을 몰라도 이해할 수 있다.

There may also be many students from the Humanities/Social Science track who could be good candidates as future physicians, and are highly skilled at communications with patients. While they may initially find it difficult to learn biochemistry, molecular biology and biostatistics, they can comprehend most of these subjects without advanced mathematics.

의사양성의 새로운 시스템으로는 다른 학과를 졸업한, 특히 인문계열 학과를 졸업한 학사학위자를 선발하는 방법이 있다. 실제로 최근 의과대학의 3993명의 교수들을 대상으로 한 설문에서 60%의 교수들은 Graduate medical school도입에 찬성하는 것으로 나타났다.

A new system for cultivating physicians might include recruitment of graduates from other departments and particularly those from the Humanities/Social Science trackIndeed, a recent survey among 3993 faculty members of medical schools throughout Japan also showed that about 60% of them were in favour of introducing graduate medical schools.6

graduate medical school을 도입하는 것이 일본 사회에 큰 도움이 될 것이다.

Introducing graduate medical schools will provide substantial benefits in Japanese society.

12. Sabalis R, Shiina K, Ishii H, Yanai H, Nara N, Saitou N. Medical Education in Japan: Changes and Challenges. Igaku Kyoiku (Medical Education) 2004;35:221-8.

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Ann Acad Med Singapore. 2008 Sep;37(9):800-2.

Introducing a new medical school system into Japan.

Tokuda Y1, Hinohara S, Fukui T.

Author information

• 1St Luke's International Hospital, Tokyo, Japan. tokuyasu@orange.ocn.ne.jp

Abstract

Entering into medical schools is the most difficult yet most prestigious among all of the undergraduate university departments. Most of the medicalstudents in Japan come from the Mathematics/Physicochemical Science track, while a few are from the Humanities/Social Science track. However, to meet the needs of the Japanese society, medical students need to learn core competencies, such as professionalism, humanism, and ethics. Issues with regard to these competencies among medical students have recently become a widespread serious concern to medical educators and the general public in Japan. In this article, we suggest that the introduction of a new medical school system, by reforming the admission criteria, can be an effective measure for meeting the current needs of the Japanese society.

PMID:

 

18989500

 

[PubMed - indexed for MEDLINE] 

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