What is it about?

We conducted a nationwide questionnaire survey asking high school teachers about the impact of economic factors and living place on students’ choice of and preparation for medical school. Responses totaling 1,094 were obtained from 1,746 high schools across Japan. The ratio of high schools with two or more students enrolled in medical schools every year is higher in private schools, those with high tuition, and those located in big cities. Approximately 66.8% of the respondents agreed that "It is difficult for students in economically disadvantaged families to enroll in medical schools;" 42.0% agreed that "Some students gave up on aspiring to enter medical schools because they could not afford it," and 61.2% agreed that "Students living in urban areas are more likely to enroll in medical schools." The results suggest that students from lower-income families and those living in rural areas are more likely to be disadvantaged when choosing a medical career than those who live in urban areas and come from wealthier families.

Featured Image

Why is it important?

In Japan, little is known about the economic factors that hinder possible candidates from applying to medical schools, partly because of the difficulty of gathering applicant information. This survey revealed that many high school teachers recognize that students from wealthy families and living in urban areas have an advantage in advancing to medical school. The responses from them imply that some students have to abandon future studies in medicine for financial reasons, suggesting the medical school entrance exam which requires specialized preparation is major problem.


To help students from disadvantaged backgrounds, the use of entrance exams that require overly specialized preparation must be reevaluated. Instead, the Common Test for University Admissions could be used as an initial screening to ensure the candidates’ academic ability to learn after entry to medical school. Thereafter, it is desirable to measure the candidates’ abilities according to the school’s admission policy, for instance, in terms of communication skills, sense of ethics, or altruistic values. In addition, it might be possible to give students with a disadvantaged background (by reference to resident area, location of the high school they graduated from, or school type) priority for enrollment in event that candidates show similar abilities.

Juinj Otaki
Tokyo Medical University

Read the Original

This page is a summary of: Factors that hinder medical career aspirations: A nationwide questionnaire survey of teachers in charge of career guidance in Japanese high schools, PLoS ONE, June 2022, PLOS, DOI: 10.1371/journal.pone.0270477.
You can read the full text:

Open access logo



The following have contributed to this page