I would like to express my gratitude to the members of the Japanese Association for Thoracic Surgery for entrusting me with the responsibilities of President of the Association following the conclusion of the term of the previous president, Professor Tabayashi. While I regard being appointed as President of this longstanding association as a great honor, I am also keenly aware of the heavy responsibility. Professor Tabayashi stated that his fundamental philosophy was to improve the features of JATS as a comprehensive association covering the three fields of cardiovascular surgery, general thoracic surgery, and esophageal surgery, and to meet the expectations of members while becoming one of Japan’s leading medical associations. He also proposed numerous measures to put this philosophy into practice. All of these measures have been moved forward or further developed, and some matters have already been achieved, while others are still in progress. I intend to emulate this fundamental philosophy, and I am determined to press boldly ahead toward the implementation of the necessary measures. Restated in different terms, this means: 1) behaving in a manner that meets the expectations of members; and 2) improving JATS with the aim of becoming one of Japan’s leading medical associations. It is the Annual Scientific Meeting and the Association’s journal that form the essence of the JATS.

• Improving the quality of the Annual Scientific Meeting
  
  My primary goal is to improve the quality of the Annual Scientific Meeting, which is the most important program of JATS. The acceptance criteria for presentations at the Annual Scientific Meeting have become more stringent over the past few years, posing a substantial hurdle for applicants. However, as a result, successful presenters can now feel even more proud of their accomplishments, and the quality of the accepted presentations is improving year by year. This is a testament to the appropriateness of the measures undertaken by JATS with respect to the Annual Scientific Meeting, and improving the quality of the meeting even further will remain my number one priority.
  
  Until now, the format of the Annual Scientific Meeting has been dealt with by the Committee on Annual Meeting while the Educational Program has been handled by the Committee on Research and Education and AATS and EACTS lecturers for the postgraduate course have been invited by the International Liaison Committee, with each committee handling matters on a case-by-case basis. The Committee on Annual Meeting comprises the chairs of Academic Scientific Meetings from the previous 2-3 years, others who also have experience organizing those Annual Scientific Meetings, and people who have chaired other associated scientific meetings. This system has had the benefit of enabling a smooth continuation of the JATS Annual Scientific Meeting as a continuous program over time, but has proved inadequate for considering the shape of the Annual Scientific Meeting itself. The greatest problem has been the difficulty in reflecting the ideas of the younger generation, who hold the key to our future, and I intend to review the committee structure and work to create a framework in which they can be included in a fundamental role within the Committee on Annual Meeting in a continuous, focused manner.
  
  
• Publication of evidence and improving the quality of the journal
  
  This objective ranks alongside my first goal of improving the quality of the Annual Scientific Meeting as a driving force for JATS.
  
  Although the surgical outcomes of JATS have now improved to the point where they surpass those in Europe and the United States, we are still lagging behind in terms of the ability to publish evidence. Although we have taken initial steps toward improving the quality of the JATS journal, General Thoracic and Cardiovascular Surgery, by moving to publication in English, further efforts are required. Although it may be to our advantage for members of JATS to publish evidence from their respective standpoints in a range of other journals, if our goal is to display the strengths of Japanese thoracic surgery, it is important for JATS that such research is published via our own journal. Just as members can feel pride in giving presentations at our own Annual Scientific Meeting, it is also vital for improving the status of JATS that we make members aware that publication of their papers in our journal is a testament to their quality. This is also an essential strategy for putting our relationships with related associations in Europe and the United States on equal footing.
  
  The Editorial Committee has worked vigorously on this issue under the leadership of Professor Miyoshi, the previous chairman, and the way forward is now clear. I intend to press ahead with improving the quality of the journal as one of my most important goals.
  
  
• Scientific surveys
  
  JATS began undertaking scientific surveys into the nature and numbers of procedures in its three constituent fields in 1986, and has now amassed data covering a 25-year period. These scientific surveys have demonstrated steady improvements in surgical outcomes for these three fields, with recent outcomes surpassing those in Europe and the United States. This is the fruit of the tireless efforts by JATS to improve clinical skills, and we can declare this to the world with pride. It will also contribute to raising the status of JATS members on the basis of their fair evaluation. A further outcome of these scientific surveys has been their role in achieving quality control of treatment. It is remarkable that JATS has a grasp of the outcomes of almost all thoracic surgical procedures performed throughout Japan, meaning that any aberrations in treatment can quickly be discovered and addressed, and the surgical outcomes thus revealed have contributed greatly to improvements in quality.
  
  One of Professor Tabayashi’s most important strategies, the “effective utilization of scientific surveys,” has been achieved through the publication of numbers and outcomes of surgical operations in the three fields of thoracic surgery. As a scientific association that is committed to upholding professionalism, I believe that JATS should also be considering what type of disclosure would be preferable as part of the debate on the extent of our involvement with the public interest. Healthcare quality control on the basis of the results of scientific surveys is another important issue.
  
  
• Medical safety and ethics
  
  There can be no excuse for ignoring medical safety and ethics on the pretext of developing thoracic surgery or medical technology. Medicine is not an autonomous academic discipline or technique that can be left to run by itself, but requires constant scrutiny to determine whether the results positively contribute to the health and welfare of patients. To endure this scrutiny requires the perseverance to await changes in the name of “progress,” as well as the courage to examine one’s own practices. The importance of preventing medical accidents, dealing with accidents sincerely when they occur, diligently searching for the cause of accidents, and working to ensure that accidents do not occur again has recently been discussed in JATS seminars on medical safety, marking the first step toward a profound recognition on the part of JATS members of the social responsibility inherent in healthcare—perseverance and courage—and this will continue to emerge as an important issue in the future.
  
  
• Specialist certification system
  
  JATS does not possess a system for the certification of specialists in thoracic surgery, but is involved with three different certification systems in the specialist fields of cardiovascular surgery, general thoracic surgery, and esophageal surgery. The extent and importance of this involvement is partly dependent on the quality of JATS, and this is connected to the reliability of the specialist certification systems with which JATS is involved.
  
  These specialist certification systems are in the process of becoming the most comprehensive specialist certification system in Japan, developed and maintained by the Japanese Board of Cardiovascular Surgery, the Japanese Board of General Thoracic Surgery, and the Japan Esophageal Society established in collaboration with the respective associations. One issue for the future is the evaluation of the quality of specialist surgeons as well as the quality of training for novice surgeons aspiring to specialist qualification.
  
  
• Improving working conditions for thoracic surgeons
  
  The Committee for Improvement in the Working Conditions of Thoracic Surgeons has carried out surveys of the actual working conditions of thoracic surgeons, and the Committee for Policy Review has also issued proposals on fees for doctors with specialist qualifications. Concrete results have yet to be achieved, however, and we will continue to make further efforts in future. The activities of the Committee on Team Approach to Health care toward the establishment of “nurse practitioners,” regarded as one aspect of improving the working conditions of thoracic surgeons, appear to be close to coming to fruition. The Ministry of Health, Labour and Welfare is due to present a bill to this year’s regular Diet session with a view to launching the Nurses’ Specified Competency Certification System in 2013. Passage of this bill can be expected to improve the nature of team medicine and raise the quality of medical treatment, as well as enabling thoracic surgeons to spend a greater proportion of their time on their essential tasks.

During my two-year term as president, I intend to devote my efforts to the development of JATS while learning from the wisdom of its members, with the continuation and reformation of our programs as my main goals. I would like to conclude my message and policy speech with the hope that by listening to the opinions of the JATS membership and gaining your support, I will be able to make JATS a trusted association of which we can all be proud.