Following the 2011 Great East Japan Earthquake and the subsequent Fukushima Daiichi nuclear accident in the coastal Hamadori region of Fukushima Prefecture, several municipalities were designated as evacuation zones due to radiological contamination. The region consequently experienced severe shortages of physicians and health care personnel. Previous studies have documented physician outflow and maldistribution in Fukushima and neighboring prefectures in the immediate post-disaster period, particularly among younger and early-career doctors.Reference Kashima, Inoue and Matsumoto^1, Reference Ochi, Tsubokura and Kato²

In response, 3 hospitals in the Hamadori region, including Soma General Hospital (~45 km north of the Fukushima Daiichi Nuclear Power Plant), Minamisoma Municipal General Hospital (~25 km north), and Jyoban Hospital (~50 km south), established postgraduate clinical training programs to attract early-career physicians during the post-disaster workforce shortage. These were hospital-based initial postgraduate clinical training programs within Japan’s national 2-year clinical training system for newly licensed physicians. They were implemented by individual hospitals in collaboration with Fukushima Medical University, Fukushima Prefecture, and local municipalities, within a national framework overseen by the Ministry of Health, Labour and Welfare. Their practical policy aim was to secure early-career physicians and rebuild local clinical capacity by creating entry points through which young doctors could begin their postgraduate careers in the Hamadori region. Although Japanese medical students and graduates can choose training hospitals nationwide through a national matching system, accredited programs are needed for disaster-affected communities to become realistic entry points for early-career physicians. This feature distinguishes the Hamadori experience from Miyagi and Iwate, where no comparable examples were identified of hospitals newly recruiting initial postgraduate trainees as a direct response to the disaster.

To explore these dynamics, we reviewed publicly available information on physicians who completed initial postgraduate training at the three hospitals in the Hamadori region: Minamisoma Municipal General Hospital (since 2013), Soma General Hospital (since 2014), and Jyoban Hospital (since 2020), up to 2025. Sources included hospital websites, newsletters, conference abstracts, and professional profiles (ResearchGate and Researchmap). Data were accessed in February 2026. Because only publicly available information was used and no identifiable personal data were included, the Jyoban Hospital ethics committee determined that ethical approval was not required.

In total, 61 trainees were identified across the 3 hospitals: 20 at Soma General Hospital, 30 at Minamisoma Municipal General Hospital, and 11 at Jyoban Hospital (Table 1). A notable finding concerns trainees’ educational backgrounds. Approximately two-thirds of trainees graduated from medical schools outside Fukushima Prefecture, indicating effective recruitment of external physicians during acute workforce shortages. In the early post-disaster period, Fukushima Medical University (FMU) graduates were underrepresented. For example, none of the first 12 trainees at Minamisoma Municipal General Hospital and only 2 of the first 6 trainees at Soma General Hospital were local alumni, suggesting that the programs initially relied on physicians from outside the region.Reference Yamamoto, Ozaki and Tanimoto³

Table 1.

Characteristics of postgraduate trainees in 3 hospitals in Hamadori after the 2011 disaster

Table 1. Long description

The table consists of 8 columns and 5 rows. The columns are: Hospital, Total identified, Currently in training, Completed training, Early (up to 2017) F M U graduates, Mid (2018 to 2021) F M U graduates, Recent (2022 to 2025) F M U graduates, and Cumulative F M U graduates.

Row 1: Soma General Hospital. Total identified: 20. Currently in training: 5. Completed training: 15. Early F M U graduates: 33 percent (2 forward slash 6). Mid F M U graduates: 43 percent (3 forward slash 7). Recent F M U graduates: 71 percent (5 forward slash 7). Cumulative F M U graduates: 50 percent (10 forward slash 20).

Row 2: Minamisoma Municipal General Hospital. Total identified: 30. Currently in training: 6. Completed training: 24. Early F M U graduates: 0 percent (0 forward slash 12). Mid F M U graduates: 14 percent (1 forward slash 7). Recent F M U graduates: 55 percent (6 forward slash 11). Cumulative F M U graduates: 23 percent (7 forward slash 30).

Row 3: Jyoban Hospital. Total identified: 11. Currently in training: 6. Completed training: 5. Early and Mid F M U graduates are not listed. Recent F M U graduates: 27 percent (3 forward slash 11). Cumulative F M U graduates: 27 percent (3 forward slash 11).

Row 4: Total. Total identified: 61. Currently in training: 17. Completed training: 44. Cumulative F M U graduates: 33 percent (20 forward slash 61).

Note: F M U stands for Fukushima Medical University. Values in parentheses indicate F M U graduates over total trainees.

Note: Values in parentheses indicate FMU graduates/total trainees.

Abbreviation: FMU = Fukushima Medical University.

Over time, trainee composition shifted toward local normalization. Recent cohorts (2022-2025) show FMU graduates comprising nearly 70% at Soma General Hospital and more than half at Minamisoma Municipal General Hospital, compared with near-zero representation in the early years. This pattern suggests a transition from emergency external recruitment to established career pathways for local medical students.

Retention after training also merits attention. Of the 61 identified trainees, 17 are currently undergoing postgraduate training in the region, and 44 have completed training. Among 29 graduates whose current practice locations could be confirmed, 14 (48%) remain working in Fukushima Prefecture. Some physicians working outside the prefecture maintain professional links with the region through part-time clinical work or postgraduate study at FMU.

Although this dataset does not capture every trainee, it provides a meaningful overview of program development over the past 15 years. In the Hamadori region, where population aging and decline had already weakened the local health care workforce before the disaster,Reference Ochi, Tsubokura and Kato² the establishment and continuation of postgraduate training programs suggest that creating local pathways for early-career physicians may be an important part of reconstructing health-service provision after disaster. These findings indicate that workforce development may function as a key pathway to recovery in aging and depopulating disaster-affected regions, by restoring physician supply, strengthening health care access, and supporting community resilience.