[Our experience with a 24-hour on-call program in Nihon University Hospitals]

We must recognize that undergraduate clinical training is insufficient in Japan and that we need to improve the role of the laboratory medicine, especially in the area of communication. Therefore, postgraduate training in clinical pathology/laboratory medicine should include; 1. Basic clinical skills (Communication skills, physical examination and common laboratory procedures such as Gram's stain, Wright-Giemsa stain, etc.), 2. Principles, instrumentation and techniques of each discipline of this broad scientific field, 3. How laboratory information is used in a medical setting, 4. The role of the clinical pathologist/laboratory physician in interacting with laboratory staff, physicians and patients. There is an increasing gap between the clinic and the laboratory. Current needs require us to make a major attempt to bridge this gap. This effort will require new and resourceful means of communication and interaction. A 24-hour on-call program was established to enrich the training of the clinical pathology residents in the USA. Each resident in the program is responsible for being on call, which entails learning the day-to-day operation of the laboratory and being available to interpret laboratory data when the need arises. Residents are expected to refer to the appropriate staff member those situations that he or she feels unable to handle. A review of all on-call problems with staff provides to be a valuable education tool, both for the residents and the staff. This learning strategy was adopted from UCSF Hospital and introduced to Nihon University Itabashi Hospital by K. Kumasaka MD in 1984. And that after 12 years of actual experience, we conclude the training program provides a readily available consultative service for the house staff, and facilitates patient care. In addition, we should make rounds with physicians and go to conferences in areas of interest and responsibilities. We could be mainly responsible for a number of problem-solving areas within the laboratory that would be directly responsive to patient problems encountered by physicians.