Present status and issues surrounding medical school entrance examinations in Japan Junji Otaki Hokkaido University Graduate School of Medicine 日本の医学部入試の現状と課題

Figures of Japanese medical education Medical schools = 80 Applicants ≒ 120,000 per year Enrollment ≒ 9000 per year Graduates ≒ 9000 per year Rate to become junior residents ≒ 99.6%

Recommendation Ministry of Health, Japan 21st century medicine and medical meetings (First report; 1996) In choosing a college to attend, so-called "academic performance for exam" has become one of the standards of judgment. As a result, high school graduates who can get high score of it tend to go on to medical school. High academic performance is necessary to be a medical professional because students must learn a lot of knowledge. However, we are skeptical that such a performance will become the basis to become a good medical person. How should we select human resources to become a medical person who will take charge of the health of the nation? It is a big challenge.

Recommendation MEXT, Japan The collaborators Conference on the research for improvement of medical education (Final report; 2007) A sufficient number of applicants in all medical schools. Ad medical students are needed to master a lot of sophisticated knowledge and skills, intellectual capacity is required. There is a need to emphasize a sense of purpose, humanity, and self-learning ability. We should not rely on only academic achievement test. The diversification of selection methods; interview, essay, report from high school, aptitude test, should be encouraged.

Recommendation Japanese Society for Medical Education Repeatedly recommended not to select enrollee only by the score of the achievement test. Have been introduced little by Interview, records of high school activities and other measurements and admission by recommendation

On the other hand Some faculties insist Need of the highest passing grade in achievement tests Not to fall out of overcrowded curriculum after admission

Status quo Achievement tests have been the center of the measure of the entrance exam.

Two issues to address About Japanese medical school entrance exam where academic ability for achievement tests is highly valued Validity of measuring an advanced academic ability Effect of education gap

Validity of measuring an advanced academic ability How we can measure “validity”?

Validity of measuring an advanced academic ability A nation wide issue “Regional quotas” – Admit many regional applicants from areas with a shortage of physicians to medical schools

Validity of measuring an advanced academic ability A nation wide issue “Regional quotas” – Do we need set the same pass levels of the achievement tests with the candidates of the general frame?

“Regional quotas” Year 2012: 68/80 medical schools 1349/8991 students

Rate of medical students Effect of Falling birthrate Year medical students were selected from 1.7 million high school graduates Year medical students from 1.2 million

Effect of education gap Societal stratification continues to develop into a major problem in Japan Educational disparities are also becoming serious

Effect of education gap Entrance exams in Japan are extremely difficult to pass Especially for students who cannot learn how to prepare for the exam at a preparatory school

Effect of education gap Tuition of prep school and medical school Very expensive….. Prep school – $30,000 - $60,000 / year Medical school – National $35,000 / 6years – Prefectural $35,000 - $45,000 / 6years – Private $210,000 - $500,000 / 6years

Effect of education gap We are concerned about the advantage of the candidates from a wealthy family, and from urban fame high school with special curriculum

For the next step To consider the current state and challenges of entrance exams in Japan from multiple angles A wide range of information should be shared and discussed Including international perspectives and experiences of foreign countries

Conclusion “Take home questions” – Do we need set the same pass levels of the achievement tests for special candidates with those of the general frame? – How and what we should do to the effect of education gap especially in the field of medical education? This symposium is the kick-off meeting for these issues