Acquisition of the Competency of Generalism and Its Association With Community-Based Clinical Clerkships at General/Family Medicine Institutions: A Cross-Sectional Study.

Authors

Yoshifumi Sugiyama, Rieko Mutai, Mariko Nakamura

Published in

Journal of general and family medicine. Volume 27. Issue 4. Pages e70145. Epub Jul 09, 2026.

Abstract

The Model Core Curriculum for Medical Education in Japan was revised in 2022, introducing a new competency, "Generalism," to the set of basic competencies required of physicians. However, it is unclear which types of medical institutions provide the optimal educational setting for acquiring the competency of Generalism through community-based clinical clerkships.
Participants were students at The Jikei University School of Medicine who participated in the Family Medicine Clerkship. Students rated, on a seven-point Likert scale (0-6), the extent to which they had acquired 18 specific competencies within the competency of Generalism. We used the Wilcoxon rank-sum test to compare total scores and scores for specific competencies by type of medical institution (general/family medicine, internal medicine, and other specialties). We used Poisson regression with robust error variance to evaluate the association between the acquisition of the competency of Generalism and the type of medical institution.
In total, 107 students participated in the Family Medicine Clerkship, of whom 69 were included in the analysis (valid response rate: 64.5%). Both the total score and scores for specific competencies related to home medical care, life processes from childhood through adulthood, and comprehensive (biopsychosocial and cultural) perspectives were higher at general/family medicine institutions. Moreover, general/family medicine institutions were significantly associated with higher total scores for the competency of Generalism (adjusted prevalence ratio 2.84, 95% confidence interval 1.20-6.71).
These findings suggest that community-based clinical clerkships at general/family medicine institutions may offer valuable educational opportunities for cultivating the competency of Generalism.

PMID:
42428721
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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