General practice / family medicine (GP/FM) is a clinical field that is expected to contribute not only to the provision of high-quality primary health care but also to medical education1). Internationally, postgraduate training has been reformed to strengthen primary health care2). Experience of GP/FM during postgraduate training is very beneficial to all junior residents, regardless of their future specialty choice3). Previous reviews have reported that GP/FM training has an impact on the management of common diseases and chronic diseases, understanding of psychosocial factors of illness, communication skills, team medical care, and community care, as well as fostering better cooperation and understanding between primary care and secondary care4,5). The findings from international literature on primary care mentioned thus far examine primary care provided by family doctors2). In 2020, the family medicine expert training program organized by the Japan Primary Care Association acquired international accreditation from the World Organization of Family Doctors6). With this accreditation, Japanese family doctors are officially recognized as family medicine specialists who have received international standard training6). However there have been few reports to date on the impact of GP/FM training in Japanese postgraduate training.
The initial postgraduate training period in Japan is two years, including one compulsory month of community medicine training in the second year7). The setting for community medicine training is selected from medical institutions in rural areas and remote islands, including hospitals with less than 200 beds, or clinics7). In addition, community medicine in Japan is practiced not only by family doctors but also by doctors from specialist backgrounds. Therefore, the training environments and programs of community medicine training vary, and community medicine training is not necessarily reflective of GP/FM training. Furthermore, since Japanese family doctors work in a variety of settings, the training environment for GP/FM is more diverse compared to countries where the majority of primary care is delivered in community clinic settings. For example, hospitals and clinics with beds treat not only outpatients but also inpatients. There are some clinics without beds that have a large need for home medical care. In all medical institutions, the faculty are certified family doctors, but to date there have been no reports regarding whether the learning of junior residents differs due to such differences in the training environment.
The purpose of the present study is to clarify the impact of Japanese GP/FM training regarding the clinical competence that should be acquired by junior residents in postgraduate training, including whether the impact varies depending on the training environment.