TRIAL OF ‘VISUALIZATION OF THE TECHNIQUES’ FOR POSTGRADUATE EDUCATION

Today's society requires specialization of physicians. In that context, we surmised that there is a need for The Jikei University School of Medicine, as an educational institution, to develop an educational system with clear, easy-to-understand targets for training of ear, nose and throat (ENT) doctors. We tried ‘visualization of the techniques’ that would simply present the targets as the number of surgical procedures, which can be expressed as numerical values, as the actual surgical performance results of physicians.<br>　We first analyzed the actual performance of the physicians at hospitals affiliated with Jikei University. The results revealed a tendency for a bias in favor of certain surgeries after approximately 10 years' experience as an ENT physician. In addition, a nationwide survey of ENT doctors revealed that after about 10 years' experience, most residents leave university hospitals to work in community hospitals and clinics. Therefore, we decided to create training targets for ENT physicians with less than 10 years' experience.<br>　Next, we carried out a questionnaire survey regarding the number of ENT surgical procedures performed by ENT doctors (n=156) at Jikei University Hospital and 5 other university hospitals and their affiliated hospitals. The results revealed 3 groupings of the target surgeries, i.e., those that could begin to be performed alone by the surgeons within less than 5 years, within less than 10 years and after 10 years. The mean values determined in that survey for the Jikei University system physicians with 10 or more years' ENT experience were higher than the mean values for the total surveyed population. Based on the concept that high targets should be set, we adopted the Jikei ENT physicians' values as the target number of procedures for the target surgeries.<br>　In this manner, we were able to establish visible targets (i.e., target numbers of surgical procedures for 25 kinds of ENT operations, and the target time periods) for training ENT physicians. To the best of our knowledge, this is the first time that such a system has been established, and we think that it is a significant step forward in ENT surgical training. We plan to put this system into effect at The Jikei University School of Medicine and investigate its effectiveness in training of ENT doctors.