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Need to reform education in graduate schools of public health in Japan: Toward outcome-based education to cultivate competencies.

Japan, known for its good healthcare access via universal health insurance, leads the world in terms of life expectancy, and possesses a public health system that has improved health standards markedly in the 20th century. However, we currently face major challenges to maintain and promote people's health. Although these complicated problems pose numerous threats to public welfare, education of public health for health professionals still retains 20th-century standards. This also means that graduate education of public health in Japan is traditionally based on obtaining licensure as a medical professional, conducting research and writing papers, and on-the-job training. Since graduate school education is expected to produce competent public health leaders, Japan requires a reform toward a new education design that caters to the current societal needs. The current global trend in the education of health professionals leans toward outcome-based education to meet core competencies. Here, "competency" refers to a set of features or particular behavioral patterns possessed by highly qualified persons. In 2006, the World Health Organization (WHO) established a general health professional competency standard that includes both management and leadership competencies. Moreover, the Lancet Commission concluded that there was a need for transformative education based on a "health system approach." In brief, this means that our education should correspond to the needs of the health system to allow for the resolution of problems by educated professionals with satisfactory levels of competencies. In addition, as "change agents," these competent professionals are expected to promote societal change toward the realization of better public health. In Japan, the Central Education Council has produced several reports on professional graduate school reform since 2000. These reports indicate that graduate school curricula require reform to allow the health professionals to work locally and globally, as well as to solve problems through the application of systematic knowledge that matches practice with theory. Therefore, with reference to the current Japanese health situation, global trends in education, and the Japanese educational policies, transformational changes are needed toward a new era of Japanese public health education specifically through outcome-based education to improve the health professionals competencies. We hope that education in the new schools of public health will contribute to solve authentic public health problems and create a healthy future with competent professionals.