The comprehensive educational approach was first taken in 1990 (MD Program 90) when the school introduced the problem-based learning (PBL) and medical communication (interview) curricula. The communication curriculum later evolved into the attitude/ethics/professionalism education program called the Human Relations curriculum. The discipline-based education became integrated education in 1994 (MD Program 94). Integrated education teaches both normal (basic) and abnormal (clinical) status of the human body based on organ systems and life cycle. After continuous improvement of the curriculum, a new curriculum was introduced in 2011 (MD Program 2011), which is the current educational model. While MD Program 2011 conserves the concepts of the integrated curriculum, PBL, and Human Relations, the new program further addresses outcome-based curriculum, community-based medical practice, scientific and critical thinking and approaches, and characteristics of women doctors.
MD Program 2011 designates 6 major competencies for medical knowledge and its application, and 5 for skills, attitudes and humanities. A total of 33 educational outcomes are further divided into roadmaps (objectives in the middle of course). The curriculum is separated into segmented education and longitudinal education (Figure 1). Segmented education is a part of the integrated curriculum. Integration of disciplines with clinical and basic medicine is based on the organ system, entire human body, and human life cycle. The first 3 and half years concentrate on studies of the integrated curriculum with 7 segments. These segments are taught through a combination of lectures, PBL tutorials, and basic and clinical practical. The final 2 and half years (3 segments) are spent on clinical training including clerkship. In addition to segmented education, there is longitudinal education. Longitudinal education refers to learning continuously over the years. These include Human Relations, Professional Writing and Expressions, Computer literacy and Statistics, and International Communications (Medical english communication). The Research Project curriculum is a basic or clinical science experience for all students to be exposed to the research environment of the university.Students are assessed by end-of-term examinations, common achievement test (Comprehensive test), and final examinations.
Simultaneously, outcome/road map evaluation is practiced as a formative assessment.
PBL was implemented at Tokyo Women’s Medical University for the first time in Japan in 1990. The educational strategy remains important in the development of competencies for problem-finding and solving. About 25% of the total time spent for education in the first 4 years is spent on PBL. PBL consists of a group discussion (100 min x 4 times for one case) and self-learning. Students experience approx. 35 cases in the first 3 and a half years.
Team-based learning (TBL)
TBL is an active form of lecture. All students sit as a team in the classroom. Students are given study projects prior to TBL and tested for how well they have prepared for their material. Answers are birst created individually and then discussed within the team. Discussions between the teams and teachers follow the in-team discussion. TBL is used to develop clinical reasoning competency in the fourth year students.
Human relations curriculum
Professional attitude, manner, communication, and ethical practice are learnt through experience, reflection, and practice in the Human Relations Curriculum. The medical school places importance on how doctors behave as professionals after graduation.
Scientific methods and thinking is a part of medicine and its practice. Students must choose one clinical or basic department to take part in research. More than 100 departments and divisions within the medical school and research institutes participate in providing this opportunity for 3rd year students. Students continue to do research after completion of the formal term.
While early clinical exposure starts as early as the 1st year, basic clinical practice training in clinical settings begins in the 4th year, and clerkship in the 5th year. Clinical clerkship includes practice in the community and the outpatient clinic, in addition to rotations in affiliated hospitals. Students may choose many disciplines according to their interests. An international exchange program is also offered as part of this clerkship, to which approximately 1/4 of our students go abroad for clerkship experience.