61558    Upon receipt of the foregoing report, the Ministry of Health and Welfare will embark on the first massive overhaul since the abolition of the hands-on training system in 1968.

61559    In Europe and the US, post-graduate training systems have been established as well.

61560    Making the clinical training compulsory seems to flow with the current of the times and there are many who will agree with this change.

61561    But it is not something that can be done easily.

61562    It will be essential for the Ministry of Health and Welfare, which will take a leadership role in the training overhaul, and the Ministry of Education, which has jurisdiction over the university hospitals that take in many interns, to pull down the government's "vertical administrative" system of agencies only looking after its scope of responsibilities and to work cooperatively.

61563    While the health ministry asked for the implementation of clinical training based on the training program starting this year, less than 50 percent of university hospitals have actually developed the program.

61564    The system to train interns in both internal medicine and surgery, or to provide comprehensive training including training in pediatrics and the emergency department in addition to the foregoing two areas, has been implemented by only a limited number of hospitals.

61565    If these circumstances continue to persist, the system of mandatory internship will not function well.

61566    Both the Ministry of Education and university hospitals should start working on the preparation for a mandatory internship system as soon as possible.

61567    While there are voices among the university hospitals arguing "training in one department is important to groom interns to become specialists in specialty areas," it should not be too late for interns to choose their specialty after having gained skills to provide holistic medical examination through the comprehensive training.

61568    From now on, the major challenge will be how to secure the funds.

61569    As approximately 13,000 interns receive clinical training every year, if they are to be properly paid based on the mandatory designation, an annual budget of as much as 40 billion yen will be needed.

61570    The upgrading of training facilities and wage hike for mentor doctors should be carried out as well.

61571    There needs to be a full discussion with related parties including the Japan Medical Association.

61572    Once clinical training becomes mandatory, interns will be unable to take part-time jobs during internship.