Background and Objectives: International electives can provide experiences for medical students to learn about health systems and foster critical self-reflection. So far, little is known about the status of Japanese students' engagement in international electives. We sought to provide information about the internationalization of Japanese medical education by clarifying the current situations of international electives. Method: We undertook a cross-sectional national 17-item questionnaire survey of program officers in all medical schools in Japan in February 2010. Results: Sixty-five (81.3%) of 80 Japanese medical schools responded to the questionnaire. 462 Japanese medical students (3% of all students in their clinical years) travelled to North America (45.5%), Asia (25.0%), or Western Europe (24.4%) to study abroad. The number of students who participated in international electives was significantly increased when academic credit was available (median 6 vs. 1, p<0.001) and institutional affiliations were present (median 7 vs. 2 students, p<0.001). Most students were evaluated by means of written assignment on return. Discussion and Conclusion: About 3% of Japanese medical students participate in international clinical exchanges. Academic credit and institutional affiliations appear to promote greater utilization of international exchange opportunities.
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