Evidence map›Paper›PMID 40685343›Full record

Observational studyBMC medical education2025

Impact of the new Japanese medical specialty system on residents' career choices in general medicine: a nationwide cross-sectional study.

Yu Yamamoto, Shuji Hatakeyama, Masami Matsumura, Soichi Koike

Abstract readObservational Study
In one paragraph

Observational study in BMC medical education, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Yu YamamotoDivision of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan. u-bou@jichi.ac.jp.
Shuji HatakeyamaDivision of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
Masami MatsumuraDivision of General Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
Soichi KoikeDivision of Health Policy and Management, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.

Funding

Health and Labour Sciences Research Grants 21IA2005
6 · The paper itself

Abstract

backgroundGeneral medicine (GM) was formally recognized as a specialty in Japan in 2018 to address the need for primary care. Understanding factors influencing GM career choices is critical for recruitment. However, the reform's impact on career decision-making remains unclear. This study examined factors influencing GM career choices following the introduction of the new specialty certification and identified challenges in this field.

methodsA secondary analysis of national survey data from the Ministry of Health, Labour and Welfare's questionnaire (2018-2020) for clinical training graduates examined post-training career intentions of specializing in GM, focusing on factors influencing choices such as demographics, education, and training contexts. Multivariable logistic regression was conducted with post-training GM preference as the dependent variable. The results are expressed as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

resultsAmong 16,674 complete responses, 59% of the 229 individuals initially interested in GM actually pursued it post-training. Positive factors included regional quotas (aOR 3.10, 95% CI 1.12-8.56), ≤ 1 month GM rotation (aOR 3.39, 95% CI 1.03-11.14), > 2 months community medicine (CM) rotations (aOR 13.35, 95% CI 2.40-76.58), desire for primary care skills (aOR 4.85, 95% CI 2.01-11.73), and community contribution aspirations (aOR 6.88, 95% CI 2.75-17.21). The most influential negative factor was perceived ease of specialization maintenance (aOR 0.01, 95% CI 0.00-0.12). Among 16,445 individuals who preferred other specialties, 86 switched to GM. Extended GM rotations (1<-≤2 months: aOR 3.54, 95% CI 2.06-6.09; >2 months: aOR 7.41, 95% CI 4.56-12.04) increased the likelihood of switching. Academic interest (aOR 0.36, 95% CI 0.23-0.58) and perceived ease of maintaining specialization (aOR 0.13, 95% CI 0.03-0.54) were negative factors.

conclusionsGM rotations may positively influence career choices, with longer CM rotations potentially increasing interest. Establishing clear career paths and educating resident physicians about the academic characteristics of GM remain challenging despite its recognition as a specialty.

Indexed as

Career ChoiceGeneral PracticeInternship and ResidencyAdultCross-Sectional StudiesEast Asian PeopleFemaleHumansJapanMaleSpecializationSurveys and QuestionnairesCareerClinical trainingGeneral medicineMedical specialtyPostgraduate medical education

Identifiers

PMID40685343
PMCPMC12278541

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.