Abstract

BackgroundRegional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors’ workload, wages, and popularity among medical students by city population sizes.MethodsWe targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents’ monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital’s information and each hospital’s website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance.ResultsThe average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas.ConclusionsHospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians’ working conditions in Japan, and such disparities need to be corrected.

Highlights

  • Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan

  • This study aimed to clarify the regional differences in hospital characteristics: doctors’ workloads and wages, and popularity among medical students based on the city population size

  • Certified teaching hospitals and classification of cities by population size In this study, we targeted the working conditions of physicians, who specialized in internal medicine

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Summary

Introduction

Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. To address the shortage of medical doctors, the number of medical school graduates has gradually increased since 2008 in Japan [1]. While the increase in doctors was large in populated cities, it was small in rural areas. Regional disparities in the number of doctors have continued since 2014 [1]. A heavy workload has a negative impact on patients [7, 8]. It is a problem of national concern

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