ArticleJournal of general internal medicine2026
A Decentralized, Academically Integrated Training Model for Rural General Practice in Japan: A Descriptive Program Evaluation.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
backgroundRural physician shortages persist globally, with professional isolation a major barrier. Traditional incentives have limited effects on long-term retention.
aimTo describe the decentralized, academically integrated training model at Shimane University General Medicine Center (SGMC) and evaluate recruitment and retention outcomes.
settingShimane Prefecture, a rural, aging region in Japan.
participantsForty-two General Practice residents (2018-2025). PROGRAM DESCRIPTION: SGMC implemented a prefecture-wide "Neural GP Network" community of practice and a "Virtual Office" using Slack and Zoom. Residents completed longitudinal rural placements in local care teams. PROGRAM EVALUATION: Annual recruitment averaged 15.8% of specialty trainees, significantly exceeding the national average (2.6%; P < 0.001). As of January 2026, 88.1% (37/42) remained in the prefectural network, exceeding estimates for rural Japan (~ 50%). The Virtual Office generated 26,787 messages and 6803 files (Feb 2024-Jan 2025). Since 2021, affiliates published 58 English-language papers. DISCUSSION: Over 8 years, this hybrid model integrating digital networking with longitudinal training was associated with strong workforce stability, representing a promising approach to strengthen rural primary care.
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