761 Vol. 34, No. 10 The movement to establish family practice in Japan started about 20 years ago, 1 and the specialty has re- cently witnessed burgeoning interest. There were 235 members of the Japanese Academy of Family Medi- cine in 1999. In just 2 years, the number climbed to 436 in September 2001 (personal communication, Tsukasa Tsuda, September 10, 2001). The first family medicine-oriented departments were established in 1981 at Kawasaki Medical School and in 1982 at Jichi Medical School. 2-3 The first true community family practice residency program opened in Hokkaido in 1997. 4 Though several academic departments and com- munity hospitals in Japan are adopting a family medi- cine approach, the Japanese government does not rec- ognize family practice ( katei iryo ) as a specialty. De- fining the scope of practice, especially with regard to inclusion of pediatrics and obstetrics and gynecology, has proven especially difficult. Still, the prospects for advancement of the discipline are bright. The Ministry of Health, Labor, and Welfare (MHL W ) recognizes the need for training in generalist care. 5 In addition, the Ministry of Education, Culture, Sports, Science, and Technology, the regulatory minis- try of medical schools, recently approved establishment of new, hospital-based departments of sogoshinryo. Sogoshinryo literally means “ integrated diagnosis and treatment,” though official translation of the term is general medicine. Of the 35 university departments of general medi- cine in Japan, some have chosen a family medicine model, others have chosen a general internal medicine model, and others yet are evolving within the context of Japanese medical culture. 6 W hile some departments have opted to establish their identity internally with fac- ulty trained in Japan, others have sent faculty members to the United States and other Western countries for advanced training. The MHL W also has sponsored Intern ati on a l F a mily Medi cin e The Ex perience s o f J apanes e Ge ner alist Phys icians in Ov ers ea s F aculty De v elopme nt Pr ograms Kazuy a Kit amura, MD; Mi ch ael D. F ett ers, MD, MPH, MA; Nobut aro Ban, MD, PhD From the Department of General Medicine, Nagoya University Hospital, Nagoya, Japan (Drs Kitamura and Ban); and the Department of Family Medicine, University of Michigan (Dr Fetters). B a c k g r o u n d a n d O b j e c t i v e s : While many resources have been invested in sending Japanese physicians for advanced training in family medicine abroad, no known research examines the nature of their experi- ences. The purpose of this research was to investigate the impact of family medicine faculty development training abroad on participating Japanese physicians. M e t h o d s : We distributed a self-administered, semi- structured questionnaire to physicians identified as having completed a faculty development program abroad. R e s u l t s : Sixteen (response rate 94%) physicians participated. The participants’ a priori goals included learning about family medicine and developing teaching skills. From observing precepting and small-group discussions, they learned new teaching approaches. Most reported their fellowship training as influencing current teaching, clinical, and research activities and as particularly enhancing their in- terest in clinical skills, learner-oriented teaching, and the doctor-patient relationship. They also reported formulating new ideas regarding teaching activities, department structure, and clinical care during their fellowships, though they have encountered barriers to implementing such reforms after returning to Ja- pan. C o n c l u s i o n s : Faculty development training abroad contributes to all major aspects of physicians’ professional lives after returning to Japan, although many report difficulties implementing new teaching ideas after their return. (Fam Med 2002;34(10):761-5.)