Introduction of Otolaryngology Outpatient Examination Training Program for junior residents as part of rural regional medical support in Japan.

Background: Nagasaki Prefecture is located in the most western part of Japan, and there are a considerable number of clinics in its many remote islands and rural areas. Thus, the Regional Medical Support Center in Nagasaki Prefecture dispatches doctors to rural hospitals to provide medical support. We introduced an outpatient training program at these rural hospitals for all residents to improve their clinical training in the field of otorhinolaryngology, whereby one otolaryngologist trains one resident.

Methods: This otolaryngology outpatient training program is randomly assigned, and conducted for 4-5 days a year, transported by a helicopter in Nagasaki Prefecture, which is a 30-minute one-way trip. We used a case checklist that included the 35 items that should be experienced and are defined as frequent by the Ministry of Health, Labor and Welfare. We also conducted a survey using an anonymous questionnaire.

Results: The survey response rate was 100%. Comparing the experience rate of symptoms between the pre-introduction resident and the post-introduction resident who underwent the otolaryngology outpatient training program, the experience rates of common diseases, including vertigo and otolaryngologic symptoms such as nasal bleeding and hoarseness, significantly increased after the program was introduced ( ≤ .001). Notably, the experience rate of headache, cough/sputum, and vertigo was 100%.

Conclusion: Our training program provides a suitable medical environment for the resident and secures a doctor who can provide secondary medical service support. Furthermore, the program will improve the level of primary care provided by the residents in remote island and rural area hospitals.