Large-Scale Observational Study on the Current Status and Challenges of General Medicine in Japan: Job Description and Required Skills

Abstract

Purpose: To identify the current ambiguous status of general medicine (GM) and assess current problems and weaknesses for further development of GM.

Patients and methods: This study adopted an observational design. GM practitioners were selected from the mailing lists of two primary professional associations for Japanese GM doctors. We included physicians currently working in a GM department, those self-described as GM doctors, and those board-certified in family medicine or general internal medicine. Respondents replied to survey questions about their sociodemographic data, job descriptions, and the requisite skills for practice. GM doctors' job description and required skills were categorized into "clinical," "management," "education," and "research." Participants (n = 971) were compared based on job descriptions and important skills in each category by facility type, size, and position.

Results: "Clinical" was indicated as the most important category for both job description and important skills, followed by "management," "education," and "research." For job description details, "follow-up outpatient" (35.6%) ranked first for "clinical," and "resident education" (57.3%) ranked first for "education." By facility type and size, job description and important skills decreased for clinical and management categories as facility sizes increased; the opposite was true for "education." "Research" was generally rated low. By position, no significant difference was found in effort or importance given to research.

Conclusion: This study is the first survey on GM physicians across Japan. The results show that while Japanese GM physicians focus on and place importance on clinical practice, they are less involved in research and do not consider research skills to be important. The challenge for the future development of GM lies in research.

Keywords: general medicine doctors; job description; observational study; research skills.

Figure 1

Participant Inclusion flow.

Figure 2

General medicine doctors’ job description and requisite skills. Participants’ responses to the items were scored as follows: 3 points to the first ranked item, 2 points to the second, 1 point to the third, and 0 points to “not applicable.” The average score was calculated for each of the four categories and was expressed as mean ± SD.

Figure 3

Job description by facility type and size. Participants’ responses to the items were scored as follows: 3 points to the first ranked item, 2 points to the second, 1 point to the third, and 0 points to “not applicable.” The average score was calculated for each of the four categories and was expressed as mean ± SD.

Figure 4

Requisite skill by facility type and size. Participants’ responses to the items: 3 points to the 1st ranked item, 2 points to the 2nd, 1 point to the 3rd, and 0 points to “not applicable.” The average was calculated for the points in each of the 4 categories. The score was calculated expressed as mean ± SD.