Accreditation, in-training exam participation and other hospital traits associated with Japanese residency popularity

A nationwide cross-sectional analysis of Japan’s 2023 physician clinical training matching cycle found that residency program popularity was associated with third-party accreditation, participation in the General Medicine In-Training Examination, urban location and several measured hospital characteristics. The abstract reports higher applicant-to-position ratios at hospitals with Japan Council for Evaluation of Postgraduate Clinical Training certification and at hospitals participating in GM-ITE®. These were statistical associations rather than evidence that either feature caused students to prefer a program.

The study included 1,029 clinical training hospitals participating in the 2023 matching cycle. Its outcome was a popularity index calculated as the number of first-choice applicants divided by the number of positions available. Predictors included JCEP certification, GM-ITE participation, urban or rural location, hospital type and facility and service measures such as permitted beds, average daily inpatients, annual ambulance transports, annual outpatient visits, average length of stay, numbers of doctors and nurses, and annual computed tomography and magnetic resonance imaging scans. Continuous variables were analyzed using multiple linear regression with natural-log transformations; the abstract reports exponentiated regression coefficients.

Among the hospitals, 31.2% held JCEP certification and 67.1% participated in GM-ITE. In the multivariable analysis, the popularity index was 12% higher at JCEP-certified hospitals than at non-certified hospitals (exponentiated coefficient 1.12; p=0.022) and 14% higher at hospitals participating in GM-ITE than at nonparticipants (1.14; p=0.011). Urban hospitals also had a higher index than rural hospitals (1.41; p<0.001). Each log-unit increase in annual ambulance transports was associated with a 15% higher index (1.15; p=0.006), while each log-unit increase in length of stay was associated with a 27% lower index (0.73; p=0.005).

University and university-branch hospitals had lower popularity indices than non-university hospitals, with exponentiated coefficients of 0.48 and 0.59, respectively; both comparisons had p<0.001. The abstract therefore identifies JCEP certification, GM-ITE participation, urban location and more annual ambulance transports as correlates of a higher applicant-to-position ratio, alongside shorter stays and non-university status. Because the reported analysis was cross-sectional and based on one national matching cycle, it cannot establish that accreditation, examination participation or any measured hospital characteristic changed program choices. The supplied evidence is an abstract from an early, open-access version that remained subject to further edits, so no additional methods or findings beyond the abstract are available here.

Subject of Research: Hospital characteristics associated with residency program popularity in Japan’s 2023 national matching cycle

Article Title: Impact of third-party accreditation and general medicine in-training examination participation on residency program popularity: a nationwide matching data analysis in Japan

Article References: Ishizuka, K., Nishizaki, Y., Kataoka, K., Katayama, K., Shikino, K., Fukui, S., Yamamoto, Y., Shimizu, T., Ohta, M., Fukui, T., & Tokuda, Y. (2026). Impact of third-party accreditation and general medicine in-training examination participation on residency program popularity: a nationwide matching data analysis in Japan. BMC Medical Education. https://doi.org/10.1186/s12909-026-10501-6

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10501-6

Keywords: medical residency, Japan, program popularity, hospital accreditation, in-training examination, matching program, urban hospitals, cross-sectional study, Impact, third-party, accreditation, general