In Japan, cardiac surgery has been placed under considerable pressure by the changing landscape of PCI. Japanese government approval of drug-eluting stents in August 2004 has seen stenting rates rise above 90% of cardiac patients, with the expanded indications for PCI leading to a reduction in surgical procedures.
Even without explicit cases involving surgical error, surgery's recent problematic record has come in for harsh criticism.
The three drawbacks associated with cardiac surgery - namely the high number of emergency cases, the relatively low wages and the fact that low patient-volumes translate to longer periods on the lower rungs of the career ladder - mean that the number of young doctors choosing cardiac surgery has fallen. This is particularly true of young women doctors, and in the modern context of female students accounting for 50% of entrants to medical school, attracting young people into cardiac surgery is a serious challenge.

Looking at the broader state of Medicine in the country, hospital administration is getting harder due to the creation of the new independent bodies administering National and Public University Medical Schools, the introduction of the new medical examination remuneration scheme (the DPC) and of "Super-rotation Training", and the reduction of the 2% of revenues received from the public purse, enforced from this year when hospital revenues fail to match costs.

These are uncertain times for Japanese Medicine, and uncertain times for cardiac surgery in this country. We cannot see exactly where we are heading, but this year's meeting will aim to furnish participants with the essential skills to thrive as a cardiac surgeon, whatever the road ahead.

This year, we are delighted to welcome Professor Hitoshi Yaku as Director of CCT Surgical. There will be eight live case demonstrations from Toyohashi Heart Center and Takahashi Hospital. CCT2005 Surgical will also provide the traditional forum for exploring our tried and trusted themes of PCI vs. CABG, improved surgical techniques, educational sessions for young doctors, sessions on healthcare finance, legal issues, and the value of science-based cardiac surgical practice.