Forward!

I extend my very best wishes for a happy New Year. I was appointed President of the Japanese Association for Thoracic Surgery in October last year. I would like to express my current aspirations for the Association.

I joined the Japanese Association for Thoracic Surgery in 1980. Since then, giving presentations at the Association’s Annual Scientific Meetings has always been a major goal in my daily clinical practice, and I would be overcome with intense emotions when I managed to achieve that goal. For all of the 35 years that have passed since then, membership in the Association has been my honor and pride. I was elected a core member in 2004. I participated in the Association as a councilor first under the former President Koichi Tabayashi since 2010 and then under the previous President Ryuzo Sakata. During this time, I served and learned much from my experience as chair of the Facility Consolidation Committee and of the Editorial Committee and as a member of the Committee for Scientific Affairs, the Annual Scientific Meeting Committee, the International Liaison Committee, and the Ethics and Safety Management Committee. I served as Congress President-Elect under Congress President Tominaga in 2014 and as Congress President in 2015.

Established in 1948, the Japanese Association for Thoracic Surgery is the oldest association of surgery in Japan. In the earliest days, 200 or so participants discussed issues mainly related to lung surgery. The Association was a leading organization to cradle the development of heart surgery in Japan beginning in the latter half of the 1950s. It is also an incontrovertible fact that the Association has supported the development of thoracic surgery and esophagus surgery from the outset. In the 1970s, the Japanese Society for Cardiovascular Surgery, the Japanese Society for Vascular Surgery, the Japan Esophageal Society, and the Japanese Association for Chest Surgery were established. Their achievements in their respective fields have been truly outstanding. This, however, does not in any way detract from the importance that the Association has in integrating the three thoracic disciplines. As the mainstream organization in the field of thoracic surgery in Japan, the Association must continue to fulfill its heavy responsibilities.

The accomplishments of the Association, owing to the efforts of our predecessors, are truly praiseworthy. I have given some thoughts to what could be added to those accomplishments and to some of the challenges we need to overcome.

The first is further improvement of the Association’s journal General Thoracic and Cardiovascular Surgery (GTCS). GTCS is one of the few journals of thoracic surgery in Japan that is written in English, and if we count the days when the title of the periodical was the Journal of the Japanese Association for Thoracic Surgery (JJATS), it has a history of more than 60 years. I remember putting considerable efforts into trying to have my paper accepted in the journal and have the paper’s title printed on its red or yellow cover page that contained the table of contents. After it began to be published in English in 1998, receiving the impact factor for the journal has become a goal of the Association. After succeeding Professor Shinichiro Miyoshi as editor-in-chief in 2012, I have made every effort to meet this goal, and through significant cooperation from our members, the impact factor of GTCS exceeded 0.70 in 2014 and is expected to reach 1.0 in 2016. Against this backdrop, I hope to try again to obtain the impact factor for GTCS. While gaining the impact factor is not the sole objective of a journal, it is my intention to pour efforts into enriching the contents of GTCS as an international journal.

Our second challenge would be the true globalization of the Association. Clinical performance in the field of thoracic surgery in Japan, as attested by the annual reports of the Committee for Scientific Affairs, is truly outstanding and is on a par with or even surpasses the level of standard clinical practice in the world. However, is this properly recognized around the world? Many international guest speakers are invited to the Association’s Annual Scientific Meetings to give presentations, but is there sufficient exchange of views between those international speakers and participants from Japan? On the other hand, even though there are more opportunities than before for Japanese speakers to be invited to scientific meetings abroad, the number of such opportunities is still not many. A countless number of students and physicians from Japan go abroad to do research or receive training, but very few young students and physicians from abroad come to Japan to receive clinical training. AATS and STS of the U.S. and EACTS and ESTS in Europe are scientific associations covering the three thoracic surgery disciplines. The Japanese Association for Thoracic Surgery is the only organization in Japan that can serve as their counterpart. With the International Liaison Committee playing a central role, we must double our efforts in meeting this challenge of globalization. In cooperation with ASCVTS in Asia, we also hope to support participants to the Annual Scientific Meetings from Asian countries.

The management of the Annual Scientific Meetings is also a challenge. The Annual Scientific Meeting, which is held every autumn with more than 3,000 Association members participating, is the largest event of the Japanese Association for Thoracic Surgery. The management of the meeting, however, is left almost entirely to the Congress President, who must carry a considerable burden of securing funding, organizing the meeting program, and selecting the venue, among others. Avoiding overlaps in the program with those of related societies and associations, namely, the Japanese Society for Cardiovascular Surgery, the Japanese Society for Vascular Surgery, Japanese Association for Chest Surgery, and the Japan Esophageal Society, also entails many difficulties. As in the case of Japan Surgical Society and the Japanese Circulation Society, I think it would be better to strengthen the Committee for the Annual Scientific Meeting and have the committee organize the program in the future. As for securing funding for the meetings, we should establish a new committee within the Association that will negotiate directly with related companies and convention services.

My next proposal is related to measures for supporting young Association members who will be leading the next generation. While the general decline of surgical practice in Japan is unfortunate, we have a significantly important responsibility to train the young generation in administering thoracic surgery. Although the Association has already implemented various measures, we need to further expand on our efforts. I am thinking about supporting young members study abroad or in different locations in Japan and establishing traveling fellowships in partnership with private companies. One of the strengths of the Japanese Association for Thoracic Surgery is that we have local chapters in various regions of Japan. I hope to seek out young surgeons who show promise in our local chapters and support them. Providing support to our women members is also an important challenge that cannot be overlooked. At present, we have over 40 female full members, but only one of them is a core member. This is a strange imbalance, considering that we have 3,000 full members over all. As women make up from 30 to 50% of students at medical schools today, we must further increase our efforts in recruiting women thoracic surgeons into the Association, in parallel with our work in improving the working conditions of thoracic surgeons and in drawing up a strategy for promoting team-based healthcare delivery.

The annual reports published by the Committee for Scientific Affairs each year have covered the majority of thoracic surgeries performed in Japan since 1984, and are a valuable asset both for Association members and society at large. Improvement in JCVSD, NCD and other databases in recent years has also made more in-depth analysis of vast amounts of data possible. On the other hand, there is a deluge of information distributed by medical institutions that is made publicly accessible through the rapid development of the Internet. However, information from individual websites and Twitter accounts is largely unregulated. Moreover, books on the ranking of medical institutions and other arbitrary dissemination of information by the mass media could potentially mislead the public. There have been discussions on how the Association should make the vast amount of information it has public. In fulfilling our social responsibility as a professional organization and in ensuring the Association’s independence, I think there is a need to have discussions, once again, on what would be just and fair in terms of our information disclosure and publication.

Described above are some of the thoughts that I have had for some time on the future development of the Japanese Association for Thoracic Surgery. The Association does have a weakness in not being able to consolidate around a single specialization and independently certify specialists, but it has an advantage in being able to pursue academic excellence as a unique scientific association integrating the three disciplines. It is my great pleasure to be able to participate or contribute in the advancement of the Association towards this goal.