Japanese and United States Family Medicine Resident Physicians' Attitudes about Training

Abstract

OBJECTIVE This is the first research known to compare residents’ attitudes about training in two countries. The objective was to examine and compare Japanese and US family medicine residents’ attitudes about their residency training. METHODS A cross-sectional survey was conducted at two Japanese sites and one US site in 1991, and repeated in 1995 at these sites, as well as two additional US sites. Family practice residents completed a self-administered, Likert scale format questionnaire containing items on demographics, identity as a family physician, resident education, the doctor-patient relationship, personal life, economic and women's issues. RESULTS The response rates were Japan, 1991: 92%(12/13); US, 1991: 76%(13/17); Japan, 1995: 89%(34/38); and US, 1995: 91%(60/66). Fewer Japanese residents reported feeling like an outsider, or discriminated against while on outside rotations. More US residents reported expectations for training were being met, and being satisfied with their education. More Japanese residents reported that outpatient training was inadequate. US residents responded more positively about the rewards of clinical decision making, patient management and the doctor-patient relationship. Japanese residents were less likely to report training as compromising their physical or mental health, or feeling overworked. Financial concerns were similar for both groups. Most female residents reported feeling that being a woman provider was an advantage. CONCLUSIONS Some aspects of family medicine training are transculturally similar, while others are influenced by the medical culture of the respective countries. Family medicine residents’ perspectives on training may be valuable to educators planning curriculum development.