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INTRODUCTION: The COVID-19 pandemic significantly disrupted medical education worldwide, highlighting critical vulnerabilities in educational continuity, especially in the context of high-stakes examinations. This study investigates how medical schools and national examination authorities in Japan responded to these challenges, focusing on the provision of make-up and alternative testing measures. METHODS: We analyzed the availability of make-up and alternative examination options in 82 Japanese medical schools and across 22 national licensing examinations for medical-related professions between 2021 and 2023. Data were collected from official websites of the Ministry of Health, Labour and Welfare, the Ministry of Education, Culture, Sports, Science and Technology, and individual university admissions materials. RESULTS: Most universities offered make-up examinations or alternative assessment options to students impacted by COVID-19, with a slight decrease in compliance over three years (82% in 2021, 80% in 2022, 76% in 2023). However, none of the national examinations for medical-related professions implemented make-up examinations or similar measures. CONCLUSION: Japanese medical schools demonstrated flexibility in adapting examination policies during the pandemic, in contrast to the rigid approach of national licensing examinations. This disparity raises important concerns regarding educational equity and public health preparedness and may also lead to significant financial hardship and career delays for affected examinees. These findings underscore the need for unified, crisis-responsive policies to support students during future health emergencies.
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Maruyama et al. (2025) studied this question.
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