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The increase in the aging population, the drastic change to a new system for postgraduate clinical training, and the lack of medical doctors have all become objects of national concern. Medical divide and melt down of the medical system brought stress especially to rural areas. Other types of stress are also found in urban University hospitals where doctors are forced to accomplish tons of paper work, while struggling on research, education, and clinical work. In this symposium, I would like to show some background and reasons for the shortage of the doctors in Japan. I also present our daily clinical practice and approach for new residents. I will also discuss the future improvement of our medical system especially in the field of Neurology. We need to show strong leadership and appeal to our comrades with medical ethics, one's dignity or self-esteem as a doctor.

Analysis of the shortage of doctors in medical university hospital in central Tokyo and plan for future improvements