ArticleBMC medical education2026
Association between community medicine rotation duration and general medicine in-training examination scores among second-year resident physicians in Japan: a nationwide cross-sectional study.
Article in BMC medical education, 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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Abstract
backgroundAlthough community medicine is a required component of postgraduate clinical training, its actual duration and relation to knowledge-based performance remain unclear. This study examined the national distribution of community medicine rotation duration and its association with General Medicine In-Training Examination (GM-ITE) performance.
methodsWe conducted a nationwide multicenter cross-sectional study using GM-ITE 2024 data from second-year resident physicians. Outcomes were compared between those with 1 month and those with 2-3 months of community medicine training. The primary outcome was the GM-ITE total score rate (%), and the prespecified secondary outcome was the correct rate (%) in the general medicine category. Other domain- and specialty-specific correct rates were examined descriptively. Multivariable linear regression was used to estimate the associations between community medicine rotation duration and total score rate.
resultsThe study included 2,834 second-year residents. Community medicine rotation duration was 1 month for 2,243 residents (79.1%), 2 months for 435 (15.3%), 3 months for 67 (2.4%), 4 months or more for 21 (0.7%), and missing for 68 (2.4%). Total score rate was similar between the one-month and 2-3-month groups (58.36±10.11 vs 58.50±10.23; p=0.785; Cohen's d=0.01). The general medicine correct rate was nominally higher in the 2-3-month group than in the one-month group (54.43±18.31 vs 52.49±17.37; p=0.031; Cohen's d=0.11), but this difference did not remain statistically significant after false discovery rate adjustment (q=0.122). In the multivariable analysis restricted to residents with 1-3 months of community medicine rotation and complete covariate data, a two-month rotation was not significantly associated with total score rate (adjusted β: 0.44; 95% CI: -0.54 to 1.42; p=0.382), whereas a small adjusted association was observed for a three-month rotation (adjusted β: 2.33; 95% CI: 0.29 to 4.37; p=0.025).
conclusionsOne month was the predominant duration of community medicine training in Japan. A small, adjusted association with the total GM-ITE score rate was observed for a three-month rotation but not for a two-month rotation, and it should be interpreted with caution. The general medicine finding was small, exploratory, and not statistically significant after adjustment for false discovery rate.
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