Lessons learned in developing family medicine residency training programs in Japan

BACKGROUND: While family medicine is not well established as a discipline in Japan, a growing number of Japanese medical schools and training hospitals have recently started sougoushinryoubu (general medicine departments). Some of these departments are incorporating a family medicine approach to residency training. We sought to learn from family medicine pioneers of these programs lessons for developing residency training. METHODS: This qualitative project utilized a long interview research design. Questions focused on four topics: 1) circumstances when becoming chair/faculty member; 2) approach to starting the program; 3) how Western ideas of family medicine were incorporated; and 4) future directions. We analyzed the data using immersion/crystallization to identify recurring themes. From the transcribed data, we selected representative quotations to illustrate them. We verified the findings by emailing the participants and obtaining feedback. RESULTS: Participants included: five chairpersons, two program directors, and three faculty members. We identified five lessons: 1) few people understand the basic concepts of family medicine; 2) developing a core curriculum is difficult; 3) start with undergraduates; 4) emphasize clinical skills; and 5) train in the community. CONCLUSION: While organizational change is difficult, the identified lessons suggest issues that merit consideration when developing a family medicine training program. Lessons from complexity science could inform application of these insights in other countries and settings newly developing residency training

The In-vehicle Router System to support Network Mobility

Abstract. This paper proposes a communication system which ensures Internet connectivity and network transparency to a group of nodes with several network interface devices. We also implement this system as Invehicle Router System. A vehicle consists of a group of nodes such as sensor nodes and devices held by passengers, is connected to the Internet through several network interface devices. It is typical for buses, trains, and airplanes to have such Mobile Internet environment, and the nodes in such vehicles have tochange the attachment point of the Internet frequently. But the nodes would then not be able to maintain transport and higher-layer connections if it changes the attachment point. Thus, it is important to provide mobility support like Mobile IP. These nodes include low cost network appliances with only limited space for extra functions. It is preferred that a solution has no impact on these low cost nodes. Therefore, existing Host Mobility Protocol is not suitable for this situation. In this article, we propose the In-vehicle Router System as a solution to this situation by combining network mobility protocol with Interface switching system. We also implement and evaluate our system on the InternetITS testbed. We have con rmed that our system provides enough functionality to satisfy the requirements of Mobile Internet vehicles.