Measuring Whole Person Health: A Scoping Review.

In Japan, all newly licensed physicians are required to complete initial clinical training before entering specialty training. This structured progression from medical school through internship to advanced specialty training is a crucial determinant of healthcare workforce distribution and specialization patterns (,). Medical institutions that provide initial clinical training foster the development of competent physicians, aligned with their institutional values and clinical practices. The acquisition of robust clinical competencies is contingent on extensive experiential learning, which is inherently dependent on the educational environment in which training occurs (). Program directors and supervising physicians often prefer residents to continue both their initial and specialty training at the same institution, as this continuity facilitates mentorship, organizational cohesion, and better workforce planning. Physician retention within the same institution represents an important goal for training institutions, particularly for those investing substantial resources in education and mentorship. Continuation of training at the same institution facilitates smooth transitions to specialty roles, preserves institutional knowledge, and enhances care continuity. These benefits are especially relevant in regions such as Saitama, where maintaining a stable physician workforce has long been challenging. However, many residents who completed their initial clinical training at Jichi Medical University, Saitama Medical Center, chose to pursue specialty training elsewhere. While several studies have examined factors influencing physicians' career decisions, including rural background, interest in primary care, satisfaction with training, and personal priorities (,), few have investigated predictors of training continuation within the same institution over time. Contemporary medical graduates increasingly prioritize diverse career goals, balancing educational quality, geographic preference, work-life balance, and specialty interest (-). While some residents value exposure to diverse clinical environments, others prioritize long-term relationships and stability within a single institution. However, the specific factors predicting whether an initial resident will remain at the same institution for advanced training remain poorly characterized. Although the Japanese specialty training matching system incorporates interviews and written assessments, the predictive value of these evaluations for future physician retention remains unclear. Identifying reliable predictors of resident retention could inform institutional recruitment and training strategies, contributing to more efficient utilization of educational resources. To facilitate readability, especially for international readers, the key terms applied in this study are defined in .