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Cohort study on regional quota graduates of medical schools and proposal of evidence-based policies

Research Project

Project/Area Number 18K10084
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
Research InstitutionHiroshima University

Principal Investigator

Matsumoto Masatoshi  広島大学, 医系科学研究科(医), 寄附講座教授 (40348016)

Co-Investigator(Kenkyū-buntansha) 前田 隆浩  長崎大学, 医歯薬学総合研究科(医学系), 教授 (40284674)
Project Period (FY) 2018-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2022: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2021: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Keywords地域枠 / 医学教育 / 医療政策 / へき地医療 / 地域医療 / コホート研究 / 奨学金
Outline of Final Research Achievements

We conducted a cohort study on the career paths of physicians who graduated from the regional quota of medical schools. The pass rate for the national medical licensing examination among scholarshiped regional quota graduates was generally higher than that of graduates from usual medical graduates. The compliance rate with obligations (the percentage of individuals fulfilling obligations without repaying scholarships) in the fifth year after graduation was 90%. The proportion of physicians working in municipalities in the bottom 1/5 in terms of population density was 65.7% in the fifth year after graduation, significantly higher than the 20.9% of general physicians. The regional quota admission system as a measure to correct physician maldistribution was shown to be effective.

Academic Significance and Societal Importance of the Research Achievements

地域枠入学制度は医師偏在是正のための国策として推進されており、現在その入学者は医学部医学科入学定員の16%を占めている。これは医師養成に関連して行われた施策としては1970~80年代の「一県一医大政策」に匹敵する規模の政策である。本コホート研究は政策としての地域枠入学制度の成果を評価した最初の学術研究である。地域枠入学制度は10年間の時限立法として開始されたが、その必要性の高さから時限を過ぎても過去最大規模のまま維持されている。今後の地域枠定員や制度運営方法について政府内および各都道府県内において検討が行われているが、本研究結果はその基礎データとなりうるものである。

Report

(7 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (19 results)

All 2023 2021 2020 2019 2018 Other

All Journal Article (5 results) (of which Peer Reviewed: 5 results,  Open Access: 3 results) Presentation (9 results) (of which Int'l Joint Research: 2 results,  Invited: 5 results) Book (1 results) Remarks (4 results)

  • [Journal Article] Ethical issues arising from the government allocation of physicians to rural areas: a case study from Japan.2023

    • Author(s)
      Matsumoto M, Aikyo T.
    • Journal Title

      J Med Ethics

      Volume: - Issue: 7 Pages: 460-465

    • DOI

      10.1136/jme-2023-108971

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Education policies to increase rural physicians in Japan: a nationwide cohort study.2021

    • Author(s)
      Matsumoto M, Matsuyama Y, Kashima S, Koike S, Okazaki Y, Kotani K, Owaki T, Ishikawa S, Iguchi S, Okazaki H, Maeda T.
    • Journal Title

      Hum Resour Health

      Volume: 19 Issue: 1 Pages: 102-102

    • DOI

      10.1186/s12960-021-00644-6

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] The emigration of regional quota graduates of Japanese medical schools to non-designated prefectures: a prospective nationwide cohort study.2019

    • Author(s)
      Yoshida S, Matsumoto M, Kashima S, Owaki T, Iguchi S, Inoue K, Tazuma S, Maeda T.
    • Journal Title

      BMJ Open

      Volume: 9 Issue: 7 Pages: e029335-e029335

    • DOI

      10.1136/bmjopen-2019-029335

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Geographical distribution of family physicians in Japan: a nationwide cross-sectional study.2019

    • Author(s)
      Yoshida S, Matsumoto M, Kashima S, Koike S, Tazuma S, Maeda T
    • Journal Title

      BMC Fam Pract

      Volume: 20 Issue: 1 Pages: 147-147

    • DOI

      10.1186/s12875-019-1040-6

    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Geographic Distribution of Regional Quota Program Graduates of Japanese Medical Schools2019

    • Author(s)
      Matsumoto Masatoshi、Kashima Saori、Owaki Tetsuhiro、Iguchi Seitaro、Inoue Kazuo、Tazuma Susumu、Maeda Takahiro
    • Journal Title

      Academic Medicine

      Volume: epub Issue: 8 Pages: 1244-1252

    • DOI

      10.1097/acm.0000000000002688

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Presentation] 研究対象としての地域医療教育:その広がりと展望2023

    • Author(s)
      松本正俊
    • Organizer
      第55回日本医学教育学会大会
    • Related Report
      2023 Annual Research Report
    • Invited
  • [Presentation] 広島県の地域枠卒業医師・医学生のキャリア形成支援と今後の展開2023

    • Author(s)
      松本正俊
    • Organizer
      第14回全国シンポジウム
    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Invited
  • [Presentation] 地域医療教育、地域枠、そして自治医科大学:歴史と成果を振り返る2021

    • Author(s)
      松本正俊
    • Organizer
      地域医療教育第53回日本医学教育学会特別シンポジウム「コロナ禍を経て見えてきた地域医療教育の進化と本質」
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 地域枠および自治医科大学出身医師の進路に関するコホート調査結果2021

    • Author(s)
      松本正俊
    • Organizer
      令和2年度全国医学部長病院長会議地域枠制度についての意見交換会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 地域枠出身医師の進路に関するコホート研究とエビデンスに基づく政策の提案2020

    • Author(s)
      松本正俊
    • Organizer
      第27回ファイザー・ヘルスリサーチフォーラム
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 地域枠出身医師の地理的分布と指定都道府県からの流出について:全国コホート研究2019

    • Author(s)
      松本正俊
    • Organizer
      第78回日本公衆衛生学会総会
    • Related Report
      2019 Research-status Report
  • [Presentation] Geographic distribution of regional quota graduates of Japanese medical schools: a nationwide cohort study.2019

    • Author(s)
      Matsumoto M, Kashima S, Regional Quota Cohort Study Group
    • Organizer
      WONCA Asia Pacific Regional Conference 2019
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] The emigration of regional quota graduates of Japanese medical schools to non-designated prefectures: a prospective nationwide cohort study2019

    • Author(s)
      Yoshida S, Matsumoto M, Regional Quota Cohort Study Group
    • Organizer
      WONCA Asia Pacific Regional Conference 2019
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] 地域枠出身医師と都道府県奨学金受給医師の国家試験合格率と義務順守率について2018

    • Author(s)
      松本正俊、大脇哲洋、井口清太郎、井上和男、前田隆浩
    • Organizer
      第50回日本医学教育学会
    • Related Report
      2018 Research-status Report
  • [Book] 地域医療白書第5号これからの地域医療を担う人たち(第3章地域枠医師)2023

    • Author(s)
      自治医科大学地域医療白書編集委員会(分担執筆者松本正俊)
    • Total Pages
      162
    • Publisher
      随想舎
    • ISBN
      4887484178
    • Related Report
      2023 Annual Research Report 2022 Research-status Report
  • [Remarks] 地域枠出身医師の進路に関するコホート研究

    • URL

      https://cbms.hiroshima-u.ac.jp/scholarship.html

    • Related Report
      2023 Annual Research Report 2022 Research-status Report 2021 Research-status Report 2020 Research-status Report
  • [Remarks] 自治医大、地域枠の卒後の就業等に関する比較研究が国際誌に掲載されました

    • URL

      https://www.jichi.ac.jp/news/research/20210901/

    • Related Report
      2021 Research-status Report
  • [Remarks] 奨学金付き地域枠、自治医科大学は地域偏在解消に有効

    • URL

      https://works.medical.nikkeibp.co.jp/articles/52146/

    • Related Report
      2021 Research-status Report
  • [Remarks] 研究について「地域枠出身医師の進路に関するコホート研究」

    • URL

      http://cbms.hiroshima-u.ac.jp/scholarship.html

    • Related Report
      2019 Research-status Report 2018 Research-status Report

URL: 

Published: 2018-04-23   Modified: 2025-01-30  

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