Evaluation of primary care practice in the University of Tokushima.

The shortage of medical doctors is now a serious social problem in Japan. There are 2.1 physicians per 1000 residents in Japan, fewer than most other OECD countries. Tokushima Prefecture has the second highest population of medical doctors in Japan, but the shortage of medical doctors in rural areas was observed by an uneven distribution. Primary care practice was started in the education of clinical clerkship for 5th grade medical students of our university since July, 2008. They round a variety of hospitals, clinics and facilities for nursing-care during one week in Kaihu county where has a severe problem in the shortage of medical doctors in Tokushima Prefecture. In order to research the efficacy of the primary care practice, we have administered a questionnaire for medical students before and after the lecture and practice, and the intensity was estimated in each student by using visual analogue scale. The results showed that the practice was more meaningful in increasing the intensity for interest and passion for community medicine and medicine in remote area than the lecture. Our data indicate that it is important to prepare more courses to learn primary care and general medicine in our clinical practice system to continue the interest and passion in community medicine.