Introduction: In this study, we compared the choice of medical specialty and subspecialty interest among problem-based-learning (PBL) graduates and non-PBL graduates. Materials and Methods: Questionnaires were mailed to a total of 1398 female doctors who graduated from Tokyo Women’s Medical University (TWMU) between 1989 and 2003. The response rate was over 30%, giving 248 respondents who had undergone a PBL curriculum (PBL+) and 220 subjects who had not (PBL-). Current specialty of the graduates were compared between the PBL+ and PBL-, and also compared with the general Japanese female doctors (Control 1 and 2) of similar age groups. Respondents were analysed in terms of their interests in subspecialty medical care or general medical practise, which includes comprehensive medical care, primary care and basic medicine. Internal medicine doctors working in the university hospitals were compared with those working outside the university hospitals. Internal medicine doctors were also compared with specialists in ophthalmology, otolaryngology, dermatology and psychiatry. Subjects were compared by odds ratio (OR) to examine group difference in the field of interest. OR >2.0 was considered statistically significant. Results: Most doctors in all groups chose internal medicine. More PBL+ internal medicine doctors showed interests in comprehensive medical care and primary care; more PBL+ internal medicine doctors working outside university hospitals showed interest in comprehensive medical care and primary care when compared with those who were working in the university hospitals. The PBL- graduates did not show such a characteristic. Conclusions: More PBL+ graduates who chose internal medicine showed interest in holistic medical practices such as primary care and community medicine and more PBL+ specialists showed sustained interest in their respective fields.
Problem-based learning (PBL) is one of the medical education strategies to promote continuous active and self-directed learning.1,2 Our medical school implemented PBL in 1990 and currently there are 800 PBL graduates who are practising physicians. Studies have shown that PBL can change learning attitudes among undergraduate students3- 5 but there is not much information available about the outcome of PBL after graduation. In this retrospective study, we investigated whether the PBL programme affected specialty choice and practise interests among PBL graduates (PBL+) and non-PBL graduates (PBL-) between the years 1989 and 2003.
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