Nihon Ishigaku Zasshi. 2002 Mar;48(1):3-30.
Nihon ishigaku zasshi. [Journal of Japanese history of medicine]
[Article in Japanese] Ichiro Tode
PMID: 12146515
Igakkan, the official medical school which was founded by Taki Mototaka (1693-1768) in 1765 and administered directly by the Tokugawa Syogunate 1791, held a medical examination in 1794. The twenty-two examinees were either young low-ranking Bakufu physicians or the sons of older official doctors. The examination consisted of four subjects: internal medicine, pediatrics, surgery, and oral medicine. For every subject, an examinee took an oral and written examination. The oral examination was generally on the differential diagnoses of diseases and pharmaceutical prescriptions for various diseases. In the written examination, an examinee was supposed to discuss a case given by an examiner-how to diagnose and to prescribe drugs to a particular patient with a certain set of symptoms. The answers were graded and commented on. Those who got good grades were rapidly promoted from the following year, while those who did not disappeared from historical records. It is conventionally believed that an official's status in the Bakufu bureaucracy was determined by his family background, but in the case of medical officials, the results of the examination mattered significantly to their later career paths.
