A culturally appropriate, student-centered curriculum on medical professionalism. Successful innovations at Keio University in Tokyo.

Professionalism is a Western concept without a precise equivalent in Asian cultures. The term itself cannot be translated directly into any Asian language, nor does the spectrum of words based on the verb "to profess" exist in any Asian language. In addition, the foundational assumptions found in the West's celebrated Charter on Medical Professionalism do not match Asian ways of thinking regarding autonomy, service, and justice. Finally, there is no tradition in Asia of reciting an oath at medical school graduations. Despite the fact that professionalism is literally a foreign concept in Asia, Keio University School of Medicine in Tokyo has successfully introduced a professionalism curriculum that both supports Japan's cultural traditions and affirms the school's academic mission. This article describes a series of educational events for medical students in the university's 6-year undergraduate program. These include development of a course on medical professionalism for students in their third year, a year-long extracurricular oath-writing project for fourth-year students, introduction of a White Coat Ceremony at the start of the fifth year (when students begin their clinical rotations), and a reflective writing requirement for sixth-year students on professionalism and humanism as witnessed during clinical rotations.