Health
A silent strike by young doctors in Japan
Key Points
Ongoing resident doctors' strikes indicate overt workforce tensions in the UK.1 By contrast, Japan faces a less visible but equally concerning “silent strike.” Despite universal health coverage, increasing numbers of young doctors are opting out of core specialties such as internal medicine, general surgery, and paediatrics.2Government data show that, between 2006 and 2024, the number of trainees under 30 declined by 48% in internal medicine, 36% in general surgery, and 17% in paediatrics.3...
Ongoing resident doctors' strikes indicate overt workforce tensions in the UK.1 By contrast, Japan faces a less visible but equally concerning “silent strike.” Despite universal health coverage, increasing numbers of young doctors are opting out of core specialties such as internal medicine, general surgery, and paediatrics.2Government data show that, between 2006 and 2024, the number of trainees under 30 declined by 48% in internal medicine, 36% in general surgery, and 17% in paediatrics.3 Meanwhile, entry into cosmetic medicine has risen 16-fold. This shift reflects structural disincentives. Cosmetic practice, outside the national insurance system, allows flexible pricing, whereas insured care is tightly regulated. Financial pressures have intensified, the proportion of clinics making a loss increasing from 24.6% in 2023 to 39.2% in 2024.4Career structures further limit choices. The specialist training system introduced in 2018 restricts mobility by tying early career doctors to financially vulnerable institutions. In addition, the 2024 work-style reform,...