Education for Community-based Family Medicine: A Social Need in the Real World.

One of the most critical social problems in Japan is the remarkable increase in the aging population. Elderly patients with a variety of complications and issues other than biomedical problems such as dementia and life support with nursing care have been also increasing. Ever since the Japanese economy started to decline after the economic bubble burst of 1991 and the Lehman Brothers bankruptcy in 2008, how we can resolve health problems of the elderly at a lower cost has become one of our most challenging social issues. On the other hand, the appropriate supply of medical and welfare resources is also a fundamental problem. The disparity of physician distribution leads to a marked lack of medical services especially in remote and rural areas of Japan. The government has been attempting to recruit physicians into rural areas through a regional quota system. Based on this background, the medical field pays a great amount of attention to community-based family medicine (CBFM). CBFM requires basic knowledge of community health and family medicine. The main people involved in CBFM are expected to be a new type of general practitioner that cares for residents in targeted communities. To improve the performance of CBFM doctors, we need to establish a better CBFM education system and assess it appropriately when needed. Here, we review the background of CBFM development and propose an effective education system.