新専門医制度における富山県の専攻医確保の現状と課題 ; Securing senior medical residents in Toyama prefecture under Japan's new specialty training system: Current status and issues

2018年度に新しい専門医制度が開始されてから４ 年が経過したが，専攻医（専門医資格の取得を目指す後期研修医）の都道府県別分布や診療科選択の傾向については明らかにされていない。今回我々は富山県の専攻医確保の現状と課題を明らかにすることを目的に， ４ 年間の都道府県別人口10万人対臨床研修医数と専攻医数，および専門診療科選択の割合を比較検討した。富山県の人口10万人対臨床研修医数は7.3人で全国平均（7.1人）を上回っていたが，専攻医数は5.0人で全国平均（7.1人）を大きく下回っていた。富山県では外科，麻酔科，産婦人科，総合診療科を選択する割合が多かったが，整形外科，放射線科，形成外科の選択が少なく，「富山県特別枠」制度（診療科を特定した修学資金貸与制度）の影響が示唆された。富山県の専攻医数は全国に比べ明らかに少なく，将来の富山県医療の継続と発展のためには，専攻医数の増加が必要である。\nJapan’s new specialty training system for senior medical residents was started in 2018, but the distribution of residents under this system and tendencies in the residents’ selection of clinical departments are not clear. For a comparison of the distribution and tendencies in Toyama prefecture with those of the national data, we determined the numbers of junior and senior residents per 100,000 population in the prefecture for the 4-year period beginning in 2018 and the percentage of each clinical department selected. We found that the number of junior residents per 100,000 population in Toyama is 7.3 (higher than the 7.1 national average), but the corresponding number of senior residents is 5.0 (far below the 7.1 national average). The percentages of residents who chose surgery, anesthesiology, obstetrics/gynecology, and general practice were relatively high, but fewer residents chose orthopedic surgery, radiology, and plastic surgery, perhaps reflecting the influence of Toyama prefecture’s study fund loan system “Toyama-ken tokubetsu-waku” that obliges residents to select designated clinical departments. The number of senior residents in Toyama is clearly too low. It is necessary to increase the numbers of residents and specialists in order to continue and develop medical care in Toyama.