Japan's residency program system and
specialist physician program.

The residency system can be divided into two stages: initial training and advanced training. The training period for initial training is approximately 2 years, while for advanced training it is more than 3 years. During initial training, residents are responsible for ward duties and emergency outpatient care while consulting with advanced residents and supervising physicians across various medical departments. In advanced training, residents belong to a specialized department and, while consulting with senior physicians, sometimes act as the primary physician for ward duties and emergency outpatient care.

The initial residency program period of two years

The purpose of the initial period of the residency program is to acquire the fundamentals as a physician. Regardless of the medical specialty, the acquisition of basic clinical skills is required. Therefore, during the two years of initial training period, various medical specialties will be covered. Specifically, over the two years, trainees will rotate through core clinical training hospitals, cooperative clinical training hospitals, and clinical training cooperation facilities (clinics and public health centers).
- Internal Medicine... 24 weeks or more
- Emergency Medicine... 12 weeks or more, can be substituted with up to 4 weeks in Anesthesiology
- Surgery, Pediatrics, Obstetrics and Gynecology, Psychiatry... each 4 weeks or more
- Community Medicine, General Outpatient... 4 weeks or more.

An advanced training of the three-year residency

The purpose of advanced residency program is to learn more deeply about specialized fields. Trainees will decide on their specialty in accordance with the new specialist system introduced in 2018 and will undergo training to acquire advanced knowledge and skills. Unlike initial residency program training, advanced residency program training may involve working as a primary physician, which comes with greater responsibility. Even among trainees, initial trainees are referred to as "trainees," while advanced trainees are distinguished as "specialty trainees" or "specialized trainees." The duration of the specialist program varies depending on the medical institutions that offer the desired clinical departments or programs. This reflects the differences between the basic specialty physicians and subspecialty physicians introduced by the new specialist system starting in April 2018. For example, if one participates in a specialist program immediately after completing initial training, it is possible to obtain specialist qualifications in emergency medicine, one of the 19 basic fields, five years after graduation. In contrast, the neurosurgery program allows for specialist qualification in the seventh year after graduating from medical school. However, to obtain a specialist qualification in cardiology, one must first complete three years of training as an internal medicine specialist, which is the basic field, and then undergo more than three years of training in the subspecialty of cardiology. Additionally, there are specialties that do not conduct linked training, such as allergology and infectious diseases, and specialties that can only be pursued after completing at least one subspecialty.