The Japan-North America Medical Exchange Foundation, Janamef, was founded 20 years ago, in 1989, to support the brightest and the best health professionals of Japan who want to study abroad, primarily in North America. Medical seminars held in Japan have helped a wide range of medical professionals, including comedical personnel, to directly experience or be introduced to medical ideas from overseas. Janamef is known worldwide as being one of the few organizations in Japan to develop the potential of the future leaders of medicine. We have supported approximately 600 physicians and held over 100 seminars and meetings. The recipients of our support have returned to Japan and are active in various fields in medicine, with results well regarded both here and abroad.

Japan excelled in specialty areas and was on the cutting edge of world medical research when our foundation began, but clinical medicine has since suffered in an extraordinarily closed atmosphere. The number of physicians willing to go abroad and put out the effort to study clinical medicine fell sharply when Japan was experiencing a high rate of economic growth. The fields of transplant medicine, infection control, intensive care and disclosure of medical information that go beyond a single specialty and require multidisciplinary teamwork fell far behind. Our foundation was started to promote medical exchange in clinical medicine and to deal with the sad state of affairs where Japanese medicine was left behind in a state of isolation and overspecialization.

Japan faces myriad issues related to medicine. Problems range from the effect on the health care system of the increasing number of elderly and decreasing number of children, the new system of health care for elderly people aged 75 and older, the effects of the new internship system for training new medical school graduates, the insufficient number of physicians specializing in high risk areas due to possible criminal charges, and the increasing failure of the medical system to work. Many of these problems have already been experienced or are being solved in other countries and their experience can be of great value to Japan.

Medical costs for the nation in 1988 when our foundation started were approximately 18.7 trillion yen (USD 1.87 trillion) or 6.3% of the total national income. Medical costs in Japan in 2007 were 334 trillion yen (approximately USD 3.34 trillion) and accounted for 9% of total national income. Total medical costs in Japan in 2025 are expected to rise to 560 trillion yen (approximately USD 5.6 trillion). Medicine is an immense growth industry.

As the population of Japan gets older and the number of children decreases, and as the awareness of patient rights for safety and quality grows, medicine in Japan, not alone but closely working with the government and society in general, must meet increasingly strong demands for the public good including improved access to emergency medicine, increased interest in homecare, facing medical issues arising from care for the elderly, and the education of a better group of medical professionals. There is much for the world to learn from Japan’s system of universal heath insurance coverage, with its success in achieving good health care outcomes even under severe capping of health care expenditures. However, there are also problems our system must face, as must the rest of the world, regarding the lack of world standard health care policies for aging societies, low general vaccination rates, physician shortages, and strategies to deal with the swine influenza pandemic. We believe that our foundation, with its international connections, can play an integral part in facilitating dialogue between the medical community and general public.

The work of our foundation has been supported by the contributions of those who agreed with our goals, including a large number of individuals, companies in the medical field, and medical institutions. At the 20th year marking of the founding of our organization, we hope to gain increasing support and understanding from an even wider range of society to continue our work in sending medical professionals to study clinical medicine in other countries, to bring together medicine and society at large, and to deepen the understanding of government authorities. We intend to further promote improved medicine through our activities and improve the health of the people of Japan.