First of all, we would like to express our heartfelt sympathy to the victims of the Noto Peninsula earthquake that occurred on New Year’s Day. We pray for the earliest possible recovery.

It is a great honor for me to assume the position of President of the Japanese Association for Thoracic Surgery (JATS), which has a long tradition. I am determined to contribute to the sustainable growth of JATS by continuing the work of the former Board of Directors, led by former President Sawa, such as 3-congress president system, the JATS-NEXT system, and the publication of the GTCC, even though we face a difficult period of change.

JATS, a unity of surgeons from three fields, is an integrated society with each field already having its own foundational society, and in a sense is in a similar position to the Japan Surgical Society. In our seeking efforts for the ideal form of an integrated society, we have already changed the format of our scientific meetings and adopted a 3-congress president system so that each of the three fields can maximize its performance. We believe that this new axis will more than contribute to the revitalization of the society, as it will allow each of the three fields to develop separately and outwardly on the same format, changing the history of JATS, which had been “trying to somehow unite three fields without true unity”. This reform will be meaningful only if it benefits not only the esophageal and chest fields, but also the cardiac field. I would like to work together with Dr. Shimizu, the Vice President, to further develop the cardiac field.

JATS must not limit itself to the academic development of the three fields, but must also work to manage the society in a problem-solving manner that responds to the demands of the times and the changes. While work-sharing associated with “the work style reform” is essential for the future of healthcare in Japan, the decline in quality must be minimized. In Japan, a so-called “Nurse Practitioner” based on the “nurse training system for specific activities,” which is slightly different from NPs and PAs in the United State, is in operation. Establishing an effective educational system for NPs, who can work for perioperative management in the thoracic surgery field, is essential for the patients. I will work with Prof. Matsumiya, Chairperson of the Team Medicine Promotion Committee, to resolve this issue. In addition to NPs, the “Revision of Laws and Regulations Concerning Medical Engineers, etc.” allows MEs to participate in VATS and MICS as camera assistants. This is a good news for hospitals with a small number of staff. We would like to adopt the changes of the times and establish the necessary systems so that thoracic surgeons can lead their sustainable lives.

Education of young surgeons is also an important issue. The Japanese Society for Cardiovascular Surgery already has a U-40, and the Japanese Association for Chest Surgery also has a Young Surgeons Education Subcommittee, each of which is active in its own right. JATS has organized the JATS-NEXT to foster academic surgeons, leaving the clinical education of young surgeons to the respective societies. The first step in clinical research begins with awareness through case reports. It is important to motivate young surgeons through the activation of regional meetings. The Case Presentation Award, which provides excellent abstracts at each regional meeting with an opportunity to present a case report at the JATS meeting, will provide an opportunity for young surgeons who are often staying in hospital and unable to participate in the meetings and experience academism. In addition, JNAC, the first academic meeting by JATS-NEXT, will be held in Osaka this year. I hope it will be a success. The JATS Fellowship provides support for young surgeons to study in Europe and the United States for 1–3 months. The International Committee is in charge of negotiating with the arranging for the surgeons to go to the desired hospitals. We have sent many young fellows to prestigious university hospitals in Europe and the United States. In addition, in the thoracic field, we are about to start a program in which fellows will move to three different hospitals in Europe for three months at a time, one month each. The first month will be in England, the next in Italy, and the last month in Vienna, and so on. We hope that you will stop by the Homecoming Session organized by the International Committee at the Annual Meeting to hear the voices of those who have studied abroad under this program.

In terms of international relations, we have been organizing the Aortic Symposium and the Mitral Conclave with AATS in the cardiac field during our scientific meetings. Last autumn, we have also signed an agreement with AATS in the thoracic field, and will hold the International Thoracic Surgical Oncology Summit (ITSOS), which is held every September in New York, as the ITSOS at JATS at this year’s annual meeting in Kanazawa. At the same time, AATS will hold the JATS at ITSOS in New York. If you have never attended ITSOS, please take this opportunity to attend ITSOS in New York. If you cannot go to New York, please join us for ITSOS at JATS in Kanazawa. This program is a single-year contract with an option to extend. We hope to make both Kanazawa and New York successful and make it an annual event. On the other hand, there are many international conferences abroad such as STS, EACTS, ESTS, ASCVTS, etc. We believe it is also necessary to organize the relationship between, contacting with each society concerned.

Recently, the Cabinet Office of Japan sent a questionnaire to each medical association through the Japanese Medical Science Federation, asking about the current status and issues regarding research and development in the medical field in Japan. I believe that although Japan still has the ability to develop new technologies, it lacks the funds to expand these technologies globally, and is currently being outbid by giant foreign companies for technologies at low prices. One of the reasons for the lack of funds is the bureaucratic system in Japan, which is in a sense excellent, but which does not allow new technologies to be given insurance points as quickly as possible. Without political action, policy guidance is not possible. With the Japan Medical Association losing power, I feel that the medical societies need to make a strong push through the Japanese Medical Science Federation.

Reform of the secretariat was initiated under the leadership of former President Sawa, but is still in its halfway. Many problems are still piling up. As the business of the association expands and the administrative workload increases, there is a serious shortage of labor in Japan. We have re-launched a committee on how the secretariat should be organized to determine what kind of secretariat is best suited for the expansion of the association’s business. We will keep a close eye on the future discussion.

Finally. The number of young people of Generation Z is increasing, and we need to find ways to encourage them to play an active role. It remains only 15 years at most that the generation that graduated from medical school and became doctors in the 20th century, when working 24 hours a day was the norm, can support this country and this academic society. I believe that steady social reform is necessary to ensure that the generation that graduated in the Showa and Heisei eras will be able to pass the baton to the next Heisei generation without dying of overwork. I would like to make every effort to ensure that medical care in the thoracic surgery field and JATS can develop sustainably while adapting itself to the times.