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POSTGRADUATE MEDICAL EDUCATION PROGRAM AT OKINAWA CHUBU HOSPITAL

The Postgraduate Medical Education Program at Okinawa Chubu Hospital is unique in Japan, in that it is organized according to the residency training programs in the USA.  The training program was begun in 1966 in order to provide a training opportunity which would attract to Okinawa, outstanding native Okinawans as well as mainland Japanese, following their graduation from medical school.  The University of Hawaii initially provided a professional staff of approximately 15, including internists, surgeons, pediatricians, obstetricians-gynecologists, physical therapists, nurses and laboratory technicians.  Over the next 5 years, the University of Hawaii team was reduced in size.  The current full time hospital professional staff includes 101 physicians, while the University of Hawaii provides 1-2 full time American Board certified faculty members located at the hospital during the year.  In addition to these, 7-15 short term consultants, come both from America and mainland Japan.  Both hospital staff and the university faculty are actively involved in the clinical teaching, although the University of Hawaii members serve primarily as consultants and advisors.

The predominant feature of the training program is the responsibility given to the interns and residents in total care of the patients under the guidance and supervision of the staffs.  The trainees develop the skills of physical examination, procedural techniques, analysis of laboratory data and the eventual logical and analytic planning of patient management.  Constant staff consultations are provided so that it becomes a continuous learning process.  Admitting rounds, ward rounds, daily conferences, grand rounds and didactic lectures form the basis of teaching. 

The self learning process is aided by a library and audiovisual center which are open 24 hours a day.  Besides the good selection of books, the library now receives 79 English and 47 Japanese journals. Pub Med, J Dream II, MD Consult, and cochrane library through internet are available for literature search.

The training program at Okinawa Chubu Hospital differs from the usual postgraduate medical education program in Japan in a number of ways.  Some are as follows:

  1. Narrow specialization is discouraged. The first year trainee rotates through Medicine, Surgery, Ob-Gyn, Pediatrics, Anesthesia & Emergency Medicine rather than limiting himself/herself to a single area, seeing patients in all areas of his/her specialty. The second year trainee specializes after rotating through psychiatry and community medicine but in broad areas such as Internal Medicine, Pediatrics, Surgery, etc... He/she is not confined to patients with diseases of a single limited subspecialty.
  2. The major responsibility for patient care belongs to the trainees under the guidance of the staffs, rather than to the full time staffs. Staff members serve as advisors, teachers and consultants to the trainees.
  3. Trainees participate actively in discussions both on the ward and in the classroom and in so doing learn to think critically and analytically about any and all statements, even those by the "professor".
  4. Trainees obtain practical experience in acute disease problems because of the hospital's active emergency room.
  5. All members of the staff are totally involved and skilled in clinical medicine. Research is performed, but it is clinical.
  6. Because of the above, the trainee become highly skilled in the principles and practice of good clinical medicine. Through his mastery of basic pathophysiological concepts, he is enabled in later years to incorporate new advances in medicine into his understanding.

THE HOSPITAL

Okinawa Chubu Hospital opened in 1946 and has steadily grown in size and capability since then.  Originally located in Okinawa City, the hospital moved in 1966 to its current location in Uruma City, approximately 3 km north of Okinawa City.

The present building was expanded in 1968 and was further enlarged in 1973 - 74 to bring the bed capacity to 433 and in 1986, to 550 beds.

In 1975, a wing occupied by pathology, nuclear medicine, C.A.T. scanner and a much expanded emergency department was opened, and in 1977, a new operating suite was built on the third floor of this wing.

 During 1979, the central clinic laboratory opened, the trainees' quarters were rehabilitated, and the X-ray department was enlarged and partially re-equipped.  During 1979, the new Newborn Intensive Care Unit, Medical-Surgical Intensive Ward and Out Patient Clinic opened.

In 1982, a five-story addition that houses Radiotherapy, Physical Therapy, Occupational Therapy, Renal Dialysis and 140 additional beds, was opened.

In 1983, the new administrative wing was opened, providing staff offices, large conference room, trainees' living quarters and additional space for radiation and endoscopy.  An Electron Microscope was installed in the Pathology Laboratory.

In 1990, a new four-story building was completed for medical records and for storage of X-ray films.  MRI was installed in 1993.

During the past 5 years, there has been an extensive reconstruction program that has produced new seven storied hospital building and most of the hospital function moved into, leaving a few ward in 2002. Old building were torn down and converted into new hospital parking lot.

The hospital is well equipped to provide the best in clinical care, Radiotherapy, Renal Dialysis, Kidney Transplant, Open-Heart Surgery, Echo, Tomography, CT Scanning, R.I. Scans, Angiography, and MRI which started in May 1994 are also available.

HOSPITAL STATISTICS IN FISCAL YEAR(April 2010 - March 2011)

1. Total Beds 550
2. Average % of bed occupancy 101.4%
3. Average days of hospitalization 12.3days
 
4. Total number of patients  
Admissions 184,388/year
Out Patient Clinic 205,000/year
Emergency Center 29,253/year
 
5. Average number of daily patients in the hospital  
Ward 505.17/day
Out Patient Clinic 726.2/day
Emergency Center 80.1/day
 
6. Total number of surgery 3,802/year
Out Patient minor surgery 2,038/year
 
7. Total number of newborns 972/year

The hospital's medical library is kept up-to-date with texts and references in English and Japanese.  Seventy-nine English language medical journals and forty-seven Japanese language journals are received regularly.  The addition of the contents of the Nanbu Iryo Center Medical library has greatly expanded the files of bound journals (in some cases back to 1935).  Pub Med and J Dream II, MD consult, and Cochrane library through internet are available for literature search.

In addition to extensive facilities for in patient care, the hospital provides the only 24-hour emergency department facilities in central Okinawa.  Trainees and staffs see an average of 80.1 patients daily in the Emergency department and on each clinic day provide care for an average of 726.2 outpatients in the Outpatient Department.

INTERNS & RESIDENTS

No. Year PGY-1 PGY-2 PGY-3 PGY-4 PGY-5 PGY-6 Total
1. 1967 8 0 0 0 0 0 8
2. 1968 12 8 0 0 0 0 20
3. 1969 13 11 0 0 0 0 24
4. 1970 14 14 0 0 0 0 28
5. 1971 11 14 0 0 0 0 25
6. 1972 17 11 0 0 0 0 28
7. 1973 14 17 0 0 0 0 31
8. 1974 22 13 0 0 0 0 35
9. 1975 17 22 0 0 0 0 39
10. 1976 16 17 8 0 0 0 41
11. 1977 16 16 9 0 0 0 41
12. 1978 16 16 12 4 0 0 48
13. 1979 18 16 10 4 0 0 48
14. 1980 16 15 15 4 0 0 50
15. 1981 22 13 12 7 0 0 54
16. 1982 22 18 10 5 0 0 55
17. 1983 24 18 10 6 0 0 58
18. 1984 21 23 12 3 0 0 59
19. 1985 21 21 14 8 0 0 64
20. 1986 21 21 12 6 0 0 60
21. 1987 22 21 11 7 0 0 61
22. 1988 24 21 12 8 0 0 65
23. 1989 23 23 12 9 0 0 67
24. 1990 23 23 15 8 0 0 69
25. 1991 26 23 12 9 0 0 70
26. 1992 22 24 10 7 0 0 63
27. 1993 23 22 10 10 0 0 65
28. 1994 22 22 11 6 0 0 61
29. 1995 21 20 10 9 0 0 60
30. 1996 21 21 10 8 0 0 60
31. 1997 20 19 12 9 0 0 60
32. 1998 23 19 8 8 0 0 58
33. 1999 22 23 11 7 0 0 64
34. 2000 22 22 11 7 0 0 62
35. 2001 22 21 9 7 0 0 59
36. 2002 21 21 14 8 0 0 65
37. 2003 23 21 11 10 0 0 65
38. 2004 34 23 15 6 0 0 78
39. 2005 34 34 15 9 0 0 92
40. 2006 27 34 20 8 0 0 89
41. 2007 27 27 19 17 4 0 94
42. 2008 24 27 14 14 7 4 90
43. 2009 23 24 23 11 8 3 92
44. 2010 22 20 16 19 9 4 90
45. 2011 27 20 17 12 5 4 85
46. 2012 29 27 15 15 2 1 89
              TOTAL  969