Impact of Japan's 2024 Physician Work-Style Reform on Pediatric Hematology-Oncology: Educational Implications in a...

Japan's 2024 physician work-style reform introduced legally binding limits on physicians' working hours, but its impact on education and workforce sustainability in pediatric hematology-oncology (PHO) remains unclear.

We conducted a repeated cross-sectional study with structured quantitative items and free-text responses. The study was carried out at institutions participating in a Japanese multicenter PHO collaborative network. Participants were heads or designated representatives of PHO units at these facilities, with 27 responses obtained in 2023 and 35 in 2024. The main outcomes were perceived impacts of the reform on clinical services, staffing, education, research activities, and workforce sustainability.

In 2023, 15/27 (55.6%) participants anticipated that medical services would be affected by the 2024 work-style reform; in 2024, 4/35 (11.4%) participants reported services were affected (29/35, 82.9% not affected; 2/35, 5.7% unsure). The impact on research or education was anticipated by 13/27 (48.1%) in 2023 and reported by 13/35 (37.1%) in 2024. In 2024, the main implementation problems were physician shortages (28/35, 80.0%) and limited task shifting or sharing (23/35, 65.7%). Free-text responses highlighted reduced clinical clerkship for medical students and bedside teaching for residents, fewer after-hours educational opportunities, and increased tasks as self-directed learning, with concerns about uneven workloads among senior physicians.

Although the reform was perceived to have limited immediate disruption of clinical services in 2024, a substantial minority of institutional representatives reported adverse effects on research or education and pervasive structural barriers. These perceived impacts on this specialist educational field warrant monitoring to safeguard future workforce capacity.