A Longitudinal Survey of Postgraduate Residency Hospital Type and Career Paths in Japan (1996-2016).

Objective To analyze the relationship between postgraduate residency hospital type and career paths in Japan. Methodology A longitudinal study based on secondary data collected from the national physician census was conducted in Japan. The sample comprised 3,991 residents for the 1996-2006 cohort and 6,153 residents for the 2004-2014 cohort. Results The percentage of residents who trained at university hospitals in their first year of registration decreased dramatically from 70% to 40% due to the 2004 mandatory clinical training reform. In contrast, the percentage of physicians working at university hospitals in their third year of registration increased from 20% to around 40%. Further, the number of physicians who had not worked at university hospitals during their first 10 years increased from 12% in 2004 to 18% in 2014. Conclusions Since the introduction of the mandatory postgraduate clinical training, residents' career paths have changed based on the residency hospital type that they attended. The resident shortage at university hospitals remains a longstanding issue in Japan.