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In order to evaluate postgraduate medical education (PGME) in Japan, residents and supervisors of all the postgraduate teaching hospitals (128 university hospitals and 216 non-university hospitals designated by the Ministry of Health and Welfare) were surveyed. The purposes of this study were, 1) to compare the goals of PGME set by residents and the achievements of PGME by residents in university hospitals and non-university hospitals, 2) to compare the goals of PGME between residents and supervisors, 3) to identify how clinical skills and knowledge related to the behavioral sciences and social medicine are stressed on PGME. Residents and supervisors received a newly developed questionnaire consisting of 41 items concerning clinical skills and knowledge. The items were divided into four categories: 17 basic areas, 9 allied areas, 12 areas related to the behavioral sciences and social medicine, and 3 areas related to clinical research. The response rate was 52.3% for university hospitals and 75.5% for non-university hospitals. The results are 1) residents in non-university hospitals scored at higher levels than residents in university hospitals for 14 items concerning goals and 11 items of achievements, mainly basic clinical skills and knowledge, 2) there was an incongruence between residents and supervisors for 23 items concerning goals, 3) clinical skills and knowledge related to the behavioral sciences and social medicine were not as highly stressed as other areas of clinical skills and knowledge. This study suggests that more effort is needed to create or improve the system of PGME, especially in university hospitals.

Environmental exposure to inhaled mineral dusts is associated with a variety of inflammatory, fibrotic and carcinogenic pulmonary diseases, generally characterized by the infiltration into the lung of phagocytic cells, namely macrophages and polymorphonuclear leucocytes (PMN). The ability of pathogenic mineral, fibrous and metalliferous dusts to stimulate PMN to produce potentially injurious free radical oxidants, has been studied using an in vitro chemiluminescent technique. The cellular mechanisms and nutritional agents involved in providing the pulmonary antioxidant biochemical defence systems are reviewed, and the prospects of dietary modification of environmentally induced lung cancers and related pneumoconiotic diseases discussed.