In Japan, medical schools must navigate a host of challenges if they are to remain competitive. Today the leaders at Tokyo Medical and Dental University (TMDU) find themselves in an environment where change is a necessity, dictated by several factors:

  • Increased competition among Japanese medical schools due to privatization and shifting demographics
  • Cultural shift changing the relationship between doctors and patients
  • Demand for innovative teaching strategies, particularly in the area of clinical skills acquisition


To meet the challenges of Japan's evolving academic medicine environment, TMDU has begun a significant curriculum reform effort. TMDU and Harvard faculty have developed a series of workshops and programs -- both in the Harvard Medical School community and in Japan -- to help the institution achieve several key objectives:
  • Create a hybrid curriculum of basic science and clinical studies
  • Develop teaching approaches, including small-group tutorials and bedside instruction, that create an active learning experience for medical students
  • Develop clerkship models
  • Institute a longitudinal patient-doctor course emphasizing professional development in areas such as communication, leadership, and medical ethics

Since this collaboration began, TMDU's stature among Japanese medical schools has risen tremendously, a fact attributable to the school's demonstrated commitment to make major strides in medical education. Its applicants rank third among Japanese medical universities, and its students score best in the country on the national examination. Highlights of the collaboration include the following:

  • Curriculum development: TMDU has made major strides in developing and implementing a curriculum that emphasizes problem-solving skills and communication over rote memorization of content. They have rolled out several new courses built around problem-based learning, built new clerkships, and launched a patient-doctor course modeled after the one used at Harvard Medical School.
  • Organizational structure development: TMDU has transitioned its curriculum development committee into an education maintenance committee. The curriculum reform initiative began with several working groups focused on different areas; the sole remaining working group is the one charged with clerkship development.
  • Faculty development: Programs to enhance faculty and leadership skills have been a staple of the partnership. Five courses in Boston have trained 55 TMDU faculty to date; more than 300 TMDU faculty have participated in programs in Tokyo led by faculty from Harvard and Ludwig Maximilians University. And TMDU has created its own faculty development program, with more than a thousand faculty participating since its inception.
  • International exchanges: Four Harvard Medical School faculty have served as visiting professors at TMDU during the last year. TMDU has also supported a popular exchange program that has enabled 24 students to complete clerkships at HMS in the last four years. The school’s efforts to revamp the structure and format of its clinical training have drawn in part on input from these students. Clifford Lo, MD, MPH, one of the HMS professors to teach at TMDU, reports, “Much progress has been made in getting students to take a more proactive role in patient care teams during their four-week clinical rotations.”
  • Evaluation and assessment: One of TMDU’s main concerns when the collaboration began was the lack of evaluation of teaching activities. The reforms to the curriculum necessitated the development of evaluation and assessment methods to match the new teaching and learning methods. TMDU has thus focused on integrating evaluation and assessment into every component of teaching, including assessment of students and clinical tutors.