Juntendo University: A World of Academics Without Borders

Today, Japan faces a pressing series of challenges, such as a lack of labor force globalization and the nation's demographic shift. The Japanese government's initiative to attract 400,000 foreign students to Japan to revamp the education system is a crucial response. What role can universities play in addressing these urgent challenges, including the need to globalize and the shortage of labor?

The government's direction is different from that of many universities. In general, universities educate people in order to activate them, allowing those people to contribute to society worldwide. Increasing the overall labor force is a governmental responsibility, so as you can see, the directions are different. Employing people from foreign countries may increase our labor force, and that is a good thing. Our purpose, however, continues to be to educate people who will contribute to society worldwide.

Japan is an island nation and is very famous for its strong private sector and technologies: being the de facto leader in various fields, from robotics to biotech for example. It is also one of the safest countries in the world, and thanks to the weakened JPY, it is now very affordable for foreigners. From your point of view, what are the main advantages of studying in Japan?

As you said, Japan’s economy is not strong right now. Living in Japan is perhaps much easier than it was ten years ago. I also agree that Japan is a very safe place to live. There are many benefits to living here; however, for foreign students, the most important thing is what they can learn from Japanese universities. Although the relative positioning of academia is a little bit lower than 30 years ago, the quality is still very good. For people looking to learn higher scientific subjects, the quality is similar to the US or Europe. The unique position of Japan is that we sit between Asia and the West. This is important from a scientific and business standpoint. Now is the best time to trial new initiatives in education.

Japanese universities don’t rank as high as their Western counterparts. Japan ranks among the best research centers, but in terms of international outlook, Japan ranks among the lowest. Do you believe that this ranking system is flawed and puts too much emphasis on international outlook?

These international rankings are only really one metric to measure universities, and honestly, there is no one true answer. We agree that a more international reputation of Japanese universities is needed, but we do understand that the quality of education here is still very good. It might come down to the isolated island mentality we have here in Japan, and this problem goes beyond just our universities. 

A big reason why we believe that Japanese universities rank low has to do with the proportion of foreign students present in tertiary education. Countries like Australia and the UK have around 25% of their student population coming from overseas, whereas in Japan this is only about 5%. How important do you believe the internationalization of faculty, staff and students is for tertiary education as a whole?

This is very important for us right now since so many industries rely on a global mindset. Japanese universities must internationalize to survive. The one big problem we have, however is language, since Japanese people’s English level is very low in general. I think it comes from a sort of inward mentality where Japanese people believe that everything can be done in Japan, and therefore they don’t need to learn to communicate with the outside world. There was a time when this was true, but times are changing, and collaboration is more important than ever. Increasing the level of English is one problem we can directly solve.

Of course, when you talk about Australia and the UK, those are two countries that both speak English as their main language. Achieving a foreigner ratio there of over 20% is actually much easier. Right now, we have about 2% foreigners in our undergraduate programs and 17% in our post-graduate programs. This averages out to above the national average, but we are looking to increase this number. For this reason, we are trying to start our English education courses, which means that the curriculum will only be taught in English. In fact, we already have some postgraduate courses in English, including those in our medical and nursing schools. This will begin fully in the autumn with the start of the new academic year.

Juntendo University (Hongo/Ochanomizu Campus) and Juntendo University Hosptial (Main Hospital)

One of the big fears that foreign students have when considering Japan as a place to study is that historically, Japanese companies have had low rates of foreign workers; however, in recent years, we have seen this begin to change. We are seeing major Japanese universities with amazing post-graduation employment of around 95%, and since the pandemic, private sector companies have tripled their employment of foreign workers. At your university, how do you bridge the gap between student life and employment post-graduation? What kind of support do you offer to foreign students to ensure that they are able to find employment after they graduate?

Our university is unique because six of our nine faculties are related to the medical field. We offer a national certificate, so if students graduate, they can easily get a job in the medical field. Three of our other faculties are the Faculty of Health and Sports Science, the Faculty of International Liberal Arts, and the Faculty of Health Data Science. Because the Faculty of Health Data Science is new, we have yet to have any graduates. Our strengths are in the medical and healthcare fields in Japan, all of which have tight connections. Currently, our Faculty of Liberal Arts has an employment ratio of about 99%, so I think it's fair to say that right now, acquiring jobs post-graduation is not problematic.

When studying the medical field in Japan, students are also positioning themselves at the forefront of Japan’s aging society issue. It is the oldest country in the world in terms of demographics, but countries like South Korea, Germany, Italy, and China are all close behind. Because of the healthcare costs that aging populations are creating for governments, we are seeing that the public and private sectors are moving from a treatment model to a prevention model. How is this change impacting your current curriculum, and how are you keeping up to date with the big challenges facing Japan?

The aging society poses many challenges for us, one of which is the shift from a treatment model to a prevention model. Geriatrics, rehabilitation medicine, and public health are the fields that are covered in detail in the educational curriculum of medical faculties. The University has a Center for Sports Medicine called the Sportology Center, which integrates medicine and sports, and is promoting research into lifestyle-related diseases and other causes of the need for nursing care and developing preventive methods to extend healthy life expectancy. The Faculty of Health and Sport Sciences also develops and provides programs to prevent frailty through the promotion of sports in the local community. In national exams, there is a section on medicine for the elderly, so, we aren’t just educating students in traditional medicine but also in treatments like rehabilitation science and physical therapy. In fact, each course we offer has a section on geriatric medicine. We also have the Tokyo Geriatric Medical Center in Koto City, which specializes in geriatric medicine. In that hospital, there are 404 beds, and observers come from China, other parts of Asia, and even Europe. 

The education field has been rocked by the emergence of generative AI, such as ChatGPT, forcing schools to rewrite their curriculums. On top of that, these digital technologies are also promoting the need for lifelong learning, the idea that a workforce must be retrained as technology advances. Your university has a partnership with Fujitsu to develop an AI prediction model for the medical field. How do you expect IT and digital technologies to impact medical education, and how are you incorporating digital technologies into the education you provide? What are you doing to support lifelong learning and the retraining of the medical workforce?

In both medical practice and education, there is an element of luck right now with people getting the opportunity to be retrained. The landscape is rapidly changing right now and I think within five years, that landscape will be totally different. You mentioned Fujitsu, but every company right now is trying to catch up with the rapid developments of AI by incorporating some sort of AI activity. This situation is true across the world.

With this in mind, we are conducting an AI and IT project encompassing the research and education fields. In the research field, we are currently developing several diagnostic AI tools. We have the AI Incubation Center to accelerate this research and innovation field. One example in the education field: we use smart glasses for better remote education. Generative AI, however, is a touchy subject, but I personally expect it to change the way we do almost everything. The real question becomes, “How do you effectively use AI within your education system?” I recently asked my staff members who understand AI to hold a lecture on this topic for faculty members. Students are using AI to write papers right now, but we are placing limits on its utilization. Everything regarding AI is changing on a daily basis.

Your university is also famous for the ethical aspect that it adds to medical studies. One of the big questions regarding the utilization of AI in the medical field is on its ethics and legality. Let’s imagine a scenario where AI is used in diagnosis, and although it recommends a procedure, the AI turns out to be wrong. Whose fault is it? What are your personal opinions on the ethical dilemmas and legal dilemmas in the medical field?

AI diagnosis should not stand alone, and there should be a human double checking it. That would solve any ethical dilemmas. Humans and AIs would collaborate on everything, including the diagnosis and the procedure. We need to check what the AI is doing at every step.

At some point, however, we lose the human aspect, the bedside manner part that operates almost like a placebo effect. It is odd, however, to think that there are those who have already said that they are in love with an AI. This may happen at times. Let’s take people with dementia as a case study. We’ve seen that those patients love robots, and I think this is because they help those patients settle down. They are calming in nature. This leads me to believe that in the future, we might be able to have AI conduct medical procedures by themselves, and then a human could check the accuracy later down the line.

Juntendo has an impressive track record of being able to fund venture companies and startups. Japan is often criticized for its lack of entrepreneurs. How does your university support the creation of bio-ventures and promote entrepreneurship among students?

We have our Research Strategy Promotion Center to assist with this topic, which particularly focuses on open innovation, research, and collaborations with companies. We also support the creation of venture companies, with our current portfolio consisting of 20 venture companies. This strategy revolves around accelerating research and bringing benefits to those companies so that further down the line, those companies can support us. If you look at a huge university such as Stanford University in the United States, there are many venture companies collaborating with them, and it has led to great success.

Historically, Juntendo University has been very medical-focused, with six of your nine faculties being oriented toward the medical field. In 2015, however, you created your Faculty of International Liberal Arts. Why did you decide to branch out of the medical field? Looking at the future, are you looking to diversify the education that you offer further?

That faculty is designed to focus on cross-cultural communication and the healthcare field. We felt a need to branch out our faculty to cover a wider area of the medical field to include the business and healthcare sides of medicine. This isn’t something a doctor would cover per se, but instead it would be specialized personnel who would cover these boundary areas. This is the catalyst that began the faculty back in 2015. 

In terms of new faculties, we are now interested in agriculture and nutrition since there are parallels with the medical industry.

This year you reached an agreement with a medical institution management consulting firm called CUC. You’ve teamed up to make a full-scale entry into medical tourism to provide advanced medical services to foreign visitors coming to Japan. This is interesting since it has a very strong commercial angle and can be seen as diversifying your revenue streams. Could you tell us more about this project and the synergies you are creating?

CUC is a medical management firm that handles medical tourism between Vietnam and Japan. Here in Japan, we have a lot of patients coming from overseas, particularly from China, Vietnam, and other Southeast Asian nations. While this is not entirely new, these days, we are seeing those numbers steadily increase. Since the Japanese insurance system is so tight, there is a need to bring in patients from outside of the country. Their needs and our needs match, but in order to be effective, we need to communicate with patients in each country adequately. This, in turn, requires offices outside of Japan, so we need companies to communicate with potential patients. Collaboration is the most effective way to conduct this business model.

How do you expect the demand for medical tourism in Japan to evolve over the upcoming years?

I think that Japanese medical treatment is world class, careful, and kind. Patients will be very satisfied with what we are doing. I personally studied in the Mayo Clinic back in 1992 when they were accepting patients from around the world including south America and the Middle East. Those patients would fly to Rochester, Minnesota, a location with around 70,000 people. Those patients from outside the US were really satisfied with the services provided by the Mayo Clinic. The same thing applies here, high-quality medical treatment and enjoyable circumstances. As a private hospital and a university, we can provide this.

Another reason why Juntendo is a good choice to cater to the medical tourism field is your overall bed capacity. Across six hospitals, you have more than 3,500 beds. We also saw in our research that you’re currently building a new facility in Saitama, which is said to open in 2027. Why did you decide to expand your hospital capacity further, and what advantages do you think this increased capacity will bring?

Our hospitals are located in key points of local areas, and we received a request from Saitama prefecture to do something similar there. There are local needs, and we are looking to cater to them.

We saw during our research that a function of Juntendo University is to help certain hospitals that can’t treat certain diseases. Those hospitals would then send patients to your hospital. Can you explain some of the areas in which you have expertise?

Since we are a university, we need to cover every area possible in the field, like a department store selling a wide range of products. We accept a variety of cases not only from Tokyo but also from all over Japan. If I were to venture to list the areas in which we focus our efforts, I would say that they are cranial nerve diseases, cardiovascular diseases, and cancer, which reflect the distribution of diseases among the Japanese population. Despite this, we also have specialized areas such as lung cancer and neurology for Parkinson’s disease.

If we look at the UK for example, the NHS hires a lot of nurses from India or Bangladesh. Japan however is a very homogenous society. Do you see a need for universities to train foreign staff as a way to onboard new labor when it comes to health care, specifically nursing, which is very labor intensive?

From our standpoint, we have two nursing faculties, and they provide nurses to our hospitals. Japan, however, does have a shortage of nurses, and along with this problem, nursing care is something that we should be concerned about, especially with the rapidly aging population. When you look at how rigid the medical systems are in Japan, it creates a situation where nurses and caregivers are not getting a fair salary when compared to other medical professional workers. This is a big problem, and it requires a change in the whole medical system. These nursing staff salaries need to catch up with other labor-intensive professions; otherwise, we will quickly run into shortages.

Juntendo is quite unique in that you have five different campuses. These include Tokyo, Shizuoka, Chiba, and others. What advantages does having five campuses offer to your university and your students?

The locations are really set by the hospitals. Once a hospital is established we generate a university facility close by. It can stimulate the interaction between hospitals and faculties as well as graduate schools, which is good from both the education and research standpoints.

We’ve seen a lot of different research studies and papers released by your university. Is there one that you are proud of and would like to highlight today?

In the area of basic research, neuroscience and immunology are particularly outstanding worldwide. In the field of neuroscience, especially in Parkinson's disease, and transplantation immunity, several translational research undertakings from basic to clinical studies are being conducted that lead the world. The research in the field of autophagy is also very active.

Looking at the future, are there any new fields that you are interested in? Where would you like to strengthen your research capabilities?

We do have an intractable disease center with genomics, and right now, it is focusing on mitochondrial dysfunction. They have discovered several new gene variants that cause mitochondrial problems. We are also looking to focus on preventative medicine, including gene analysis. In this project in particular, we are researching with life insurance companies in order to provide genome surveys to individuals, allowing us to identify signs of the disease early. In addition, we are currently establishing a biobank of data that would assist in the development of precision medicine.

As mentioned throughout this interview, you’ve had several impactful partnerships with both other institutions and private sector companies. Are you currently looking for similar types of partnerships? If so, what does a partner of choice look like?

Right now I’m particularly interested in generative AI. This is vital in the discovery of new drugs and in better disease diagnosis. It is also true that AI would change the medical and research work flow, and for that reason I’m trying to establish collaborations with generative AI companies to make a new operating system for research centers and hospitals. These technologies are going to change the world.

You have a wide network of international partner universities, including Johns Hopkins in Baltimore, Maryland. You have more than 70 partners across 30 countries. Looking at the future, how do you expect this partnership network to continue to evolve?

We have a very tight connection with Johns Hopkins right now. There were exchanges, and communication between us was very good. We’ve also begun discussions with Harvard University and Mahidol University in Thailand. In addition, we’ve also established a research project with Beijing University. There are many ways we are moving this network forward and continuing to evolve our connections around the globe. Another strategy we are taking is to deepen already established connections with partner institutions.

Fortunately, with the Association of Southeast Asian Nations (ASEAN), there is a framework in place to create further collaborations. Perhaps in the future we will need the skills of the people of ASEAN to mitigate our personnel shortages.

Do you have any plans to open a campus or office in the ASEAN region?

I did some research, and I’m currently writing a paper, but a core element is that the education systems are quite different from country to country. Japan, Korea, and Taiwan are similar, but things are very different in Southeast Asia. We need to better harmonize our systems first before this becomes an option.

Imagine that we come back and have this interview all over again on the last day of your presidency. What goals or dreams do you hope to achieve by the time you are ready to pass the baton onto the next generation of Juntendo University executives?

Firstly, generative AI is going to completely change the education institutes of the world. Just within the next five years, I believe things will change very rapidly. From a university standpoint, our target is international collaboration, and projects like this are going to be critical to the future development of medicine and health care. In order to further these projects, international students and globalization are essential.

For more information, visit their website at: https://en.juntendo.ac.jp/