Geographical Distribution of Ophthalmologists Before and After the New Postgraduate Training Program in Japan

Purpose: To assess the geographical distribution of ophthalmologists in Japan before and after the start of a new postgraduate training program, which was suggested to exacerbate the uneven distribution of physicians. Methods: The number of physician per million population was calculated for ophthalmologists by using adjusted municipal boundaries and the data from physician censuses performed in 1996 and 2006, as well as the population censuses performed in 1995 and 2005, respectively. The Gini coefficients, income inequality measure that ranges from 0 (perfect equality) to 1 (perfect inequality), and 95% confidence intervals (95% CIs) were computed from the Lorenz curves for the 2 periods. Results: The total number of ophthalmologists increased from 10,982 to 12,362 over the last decade. The Gini coefficient (95% CI) for ophthalmologists was 0.405 (0.314-0.496) and 0.353 (0.272-0.434) in 1996 and 2006, respectively. Conclusions: The geographical distribution of ophthalmologists in 2006 was better than that in 1996, although there was no statistically significant change. There is no evidence that the new postgraduate training program encouraged an imbalance in the geographical distribution of ophthalmologists.