Table 2 Themes and their detailed explanations about what medical students gained from the FT

Spirit of scientific inquiry

Ability to perform objective judgment toward radiation health risk

The ability to judge truth or falsity toward the topic of radiation health risk and radiation management, critically examining current information such as media reports.

“To be honest, I was afraid to visit the FDNPP since I heard negative topics of the FDNPP from media. When I actually visited the site and checked the dose rates during the tour, I found that, from a scientific point of view, the dose rates were not high enough to cause harm to the human body.” (Subject B)

“I was interested in the radiation management of the FDNPP restoration workers. I assume that each worker has a different background, such as level of education, so how have they been trained? The appropriate training may be different depending on the level of education. Without such appropriate training, the health of the workers may be at high risk. Beyond the explanation of the spokespersons, we need objective information to judge the risk of radiation and quality radiation management. This is what I knew through the FTDA.” (Subject D)

Field-based knowledge of FDNPP restoration situation

Updated knowledge of the status of FDNPP restoration based on actual field observation (FTDA), taking into account the consequences of the restoration.

“Visiting a nuclear power plant was a special experience for me. My local friends were losing interest in the FDNPP accident and its recovery, so I was able to revive their interest by telling them about my experience of visiting the plant, such as the reality of radiation protection, the fact that the radiation dose was lower than expected, and the expectation that future recovery will not be an easy process. It was a good experience for me to know what the situation was really like at the FDNPP.” (Subject A)

“During the FT to the FDNPP, I was introduced to groundwater and sewage water control equipment to prevent radioactively contaminated water from leaking into the ocean, such as ALPS*, waterproof walls, and groundwater bypasses. I was surprised that such technologies actually existed and were being used. However, there is still a lot of contaminated water and materials temporarily stored on the premises of the FDNPP that have not yet been disposed of. I thought their disposal would be a significant issue in the future.” (Subject B)

*Note: ALPS (Advanced Liquid Processing System) is a system to remove radioactive materials from contaminated water, reducing the radiation dose to meet national safety standards by chemical and physical technologies.

Foundation for lifelong education and personal growth

Deeper understanding of the appeal of public health and preventive medicine

Discovery and/or enhanced understanding of the appeal of occupational health and preventive medicine from the viewpoint of practice.

“I have taken many clinical courses in my practical training, for example, the bedside learning program. However, it was not until I took part in the FT that I fully understood preventive medicine or public health. I gained an understanding that taking care of workers’ safety, for example, preventing industrial accidents is one of the central issues in preventive medicine and occupational/public health. In order to support the health of workers, we need to know about their backgrounds, such as their working conditions and education level. It may become my life’s work.” (Subject B)

“The work of doctors is often thought of as ‘curing disease’, or so I thought. That may be true. However, occupational health and preventive medicine are about helping people to be more fulfilled in their daily lives and work. It was good to know there are ways to provide this kind of health care and its attractiveness.” (Subject C)

Enjoyment of problem finding and solving

Recognition of the fun in problem finding and solving itself, not just in the context of medical practice.

“I have been interested in public health since my fourth year at university. I enjoy and like thinking about health problems and how to tackle them using statistics. The FT has allowed me to talk to people, not just statistics. When you come into contact with data, whether numbers or stories, you get to know new aspects of people. It’s an exciting process to think about what the problem is and how I can improve it.” (Subject C)

“I learned the advantages and fun of FTs and interviews. These methods are quite attractive for finding health issues and solutions for workers. It was my first time joining a practical training like the FT to the FDNPP, but I enjoyed it. This is a unique educational course.” (Subject D)

Broadened understanding of the medical profession

Career path to an ideal doctor

A broadened view of how to work as a medical doctor, with the conviction that a medical doctor can improve health problems by understanding the social background and life of their patient.

“My experience of the trip to the FDNPP had a lasting impression on me. There is a way of being a doctor who may not directly cure patients but can contribute to workers’ health by paying close attention to the background. I think such a background is called humanity: the way of living and human relationships established by the workers. Such attention to the background is essential for an eventual understanding of the person.” (Subject A)

“When I see patients in surgical training, I don’t really look at the patient’s background. The FT, on the other hand, allowed me to focus on the patient’s humanity. It was certainly very different from learning in the classroom. As a surgeon, and in other areas of medicine, you should be interested in the patient’s life. I want to keep that perspective.” (Subject C)

Mental preparation by observation to clarify the ideal way to proceed

Reflections on how to work as a medical professional in the future, based on the working practices and health support needs of the people met through FT.

“Being a doctor and dealing with a patient who gets sick is indeed good. But I have been exposed to preventive medicine and its idea. If I can save thousands of people before they get sick, that is a better way. In the future, I will meet patients and residents who should be treated with the idea of prevention. This training (a six-week intensive course in social medicine) may have been a preparation for that. This is a very promising future path for me.” (Subject A)

“In my case, before I entered medical school, I thought that the main job of a medical doctor was to perform surgery. However, I learned various things after entering school and saw different paths. Honestly, I have decided on the department I want to enter, and the department has nothing to do with disaster medicine or radiology. After I get into it, I may develop an interest in other things. This development should be taken as a positive sign. The FT to the FDNPP allowed me to discover such positive viewpoints and possible career options.” (Subject C)

Variety of ways doctors can support society

Insights into how medical doctors contribute to society, focusing on the status and value they hold in society rather than on their competencies, such as knowledge and skills.

“It is rewarding to serve others, but that service is not limited to being thanked for curing illnesses. A medical doctor may contribute to an organisation with an installation criterion in law that requires the presence of a medical doctor just by belonging to it since the organisation must need a professional with a license. In this way, if I can be useful as a doctor by helping others, I can contribute in various ways.” (Subject B)

“For better or worse, even if you say the same thing, it can be more convincing when a doctor says it. Doctors need to see that they have such a position in society. It is not just about curing diseases; by showing up as a doctor and communicating with patients, patients may be able to feel health advice as reassuring and convincing. Doctors take advantage of their strong position, but it makes sense if they can realistically contribute to health. There are many ways in which a doctor can be helpful to society.” (Subject D)

Importance of practicing medicine in the community setting

The reality of medically underserved areas as a potential workplace

A sense of one’s responsibility or mission considering the social situation regarding medical care in the disaster-affected area.

“There is a new hospital in the city near the FDNPP. This hospital is closely linked to the university’s medical department. If I become a professional doctor and work at the university, I could be sent to this hospital. Even within the same prefecture, this area has a smaller population and fewer medical resources than this area (where the university is located), so there are specific challenges. There are many older adults, and there is a need for occupational health care for the recovery workers. If I work at this hospital, I need to address these challenges.” (Subject B)

“I had to go to the Hamadori area* in Fukushima Prefecture for practical training after this laboratory assignment program. From the practical training, I realised the severity of medically underserved areas, and I thought that the FDNPP greatly impacted the area. After graduation, I plan to work in Fukushima Prefecture, so I may stay and work in the Hamadori area. If I do, the impact of the FDNPP accident will be related to my work, although it may be indirect.” (Subject D)

* Note: The Hamadori area is the coastal region of the Prefecture on the east side. It is the region where the FDNPP is located and is faced with limited medical resources.