Postgraduate medical training in anatomical pathology in Japanese national universities

In Japan, pathologists are not well recognized as clinicians. There is no nation-wide postgraduate medical training(PGMT) system for anatomical pathology(AP). PGMT of AP is performed in the department of pathology(DP) in the basic medicine(BM) in individual medical schools(MS). However, the main research field of DP of BM has gradually changed from early AP to late experimental pathology(EP), and in the recent years PGMT for AP in MS appears to be performed during intervals between EP, and good PGMT for AP is not available in the majority of MS. The diagnostic pathology division(DPD) in national university hospitals(UH) was established in Tohoku UH in 1972. Since then DPD has been established in 33 of 42 national UHs to date. Moreover, 2-years obligatory system of postgraduate clinical education was set out by the Japanese Ministry of Health, Labor and Welfare in 1994, and was arranged to start from 2004. Under these circumstances, PGMT for AP in the majority of national MSs will likely be performed in DPD of UH. However, there are not sufficient numbers of staff for PGMT usually available in DPD of UH only, and residency program for PGMT in AP has already been established in only 21 of 42 national MS and actual training courses for AP have been started in only 13 of 42 UHs to date. PGMT for AP should be performed mainly in DPD of UH, together with the help of DP of BM, and DPD of related hospitals to obtain sufficient staff, and should be arranged as a 5-year course with initial 2-year and late 3-year training system to obtain board certification by the Japanese Society of Pathology.