Anesthesia Credentialing in Japan

Anesthesia credentialing in Japan is provided by the JSA, the Japanese Medical Specialty Board, and by the Ministry of Health, Labour and Welfare (MHLW) at several levels.

Registered Anesthesiologist: ‘hyobo-i’

The first level is ‘hyobo-i’ or Registered Anesthesiologist. Registration is conducted by MHLW in accordance with Japanese law (the Medical Care Act), and grants legal permission to present oneself as a provider of anesthesia services. Licensed physicians in Japan who meet the following criteria are eligible for registration: 1. Completed at least two years of full-time clinical anesthesia training, and 2. Served as primary anesthesia provider for over 300 cases of general anesthesia with endotracheal intubation. Registration does not require renewal.

JSA Qualified Anesthesiologist: ‘nintei-i’

Registered Anesthesiologists who are JSA members in good standing may apply for qualification as ‘nintei-i’ or JSA Qualified Anesthesiologist. Qualification can be renewed every 5 years by earning at least 20 academic credits. Participation in one JSA Annual Meeting (required) is 15 credits, with additional credits available for other meetings and continuing education activities, such as e-learning programs provided by the JSA.

Board Certified Anesthesiologist: ‘senmon-i’

Specialist certification in Japan is administered via professional societies such as the JSA, and is transitioning to a more centrally managed model under the Japanese Medical Specialty Board. Under the current training system, junior physicians enter a four-year training program towards anesthesia specialist certification as a ‘senmon-i’ or JSA Board Certified Anesthesiologists.

Candidates must pass a written, oral, and practical exam in addition to completing the requirements of their four-year training program, which includes a minimum number of clinical case experiences. These include anesthesia experience as primary anesthesiologist for at least 10 cesarean sections, 25 thoracic surgery cases, and 25 neurosurgery cases. Experience as primary or secondary anesthesiologist is required for at least 25 cardiovascular cases (including the thoracic aorta), and at least 25 pediatric cases (<6 years of age). Aside from clinical experience, a total of 10 required credits must be earned by participating in academic meetings and continuing education activities. Current AHA-ACLS or PALS provider status is also required.

Board Certification is renewed every 5 years. Conditions for renewal currently include a continued full-time (at least 3 days a week) commitment to anesthesia-related duties at a single institution. Exemptions may be granted for up to two years for pregnancy and maternity, basic research, study abroad, etc.

Clinical and academic credits (50 required for renewal) may be earned for clinical duties and participation in meetings and continuing education activities. There is no exam for renewal of board certification.

Fellow of the JSA: ‘shido-i’

‘Shido-i’ means teaching physician, and is an honorific title for Fellows of the Japanese Society of Anesthesiologists. Candidates must be board certified members in good standing, and have completed at least 7 consecutive years of full-time anesthesia-related duties. Additional required credits may be earned for clinical duties and participation in academic meetings and continuing education activities, or by appointment to an official responsibility (such as president, dean, director, honorary member, etc.). JSA Fellowship is renewed concurrently with renewal of board certification every 5 years.

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