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J Rural Med. 2018 May;13(1):11-17. doi: 10.2185/jrm.2950. Epub 2018 May 29.

What do medical residents learn on a rural Japanese island?

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Unnan City Hospital, Japan.
International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Japan.


Objective: Community-based medical education (CBME) serves as a complement to university medical education, and it is practiced in several urban undergraduate and postgraduate curriculums. However, there are few reports on CBME learning content in rural Japanese settings. Materials and Methods: This research aimed to clarify learning content through semi-structured interviews and qualitative analysis of second-year residents who studied on a remote, rural island located 400 km from the mainland of Okinawa, Japan. Analysis was based on Steps for Coding and Theorization (SCAT). Results: Fifteen concepts were extracted, and four categories were generated: a strong connection among the islanders, the necessary abilities for rural physicians, islander-centered care, and the differences between rural and hospital medicine. In contrast to hospital medicine, various kinds of learning occurred in deep relationships with the islanders. Conclusion: Through CBME on a remote island, the residents learned not only about medical aspects, but also the importance of community health through the social and cultural aspects, whole-person medical care in a remote location, and the importance of reflection in their self-directed learning.


community-based medical education; postgraduate; rural medicine; self-directed learning; whole-person medical care

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