Yukio Yuzawa: Confronting Population Decline


Japanese students lose out because they don’t study abroad, Yukio Yuzawa said. Despite the dwindling number of college-aged people in Japan and the threat it poses to higher education, the president of Fujita Health University in Aichi wants students to experience the rest of the world.

“It’s not just due to the Covid-19 pandemic,” says Yuzawa. “Lately, the young Japanese generations no longer want to go abroad. It’s a big problem.”

In the latest interview in our Talking Leadership series, the trained physician and kidney specialist discusses the major demographic shifts underway in Japan, the fallout from the 2018 medical school admissions scandal, and the future of medicine.

The benefits of internationalization

Students from other Asian countries, such as China and Korea, are studying abroad in droves and then returning to their home countries to become leaders in their fields. Japan, too, used to embrace this tradition, but due to an economic downturn in recent decades, students stayed put, says Yuzawa. This applies not only to entire courses abroad, but also to studying abroad for semesters, he adds.

They miss out on the mentors they could meet and the global network of future experts in their field. But, more importantly, students fail to realize that the Japanese way of doing things is not the only one.

“There is a big gap between Japanese common sense and the world, universal common sense,” he says. “We shouldn’t follow the UK or US way of thinking. We should keep our own Japanese system. But you have to know the weak points and also the advantages of the Japanese system. If we don’t go out [abroad]we don’t have the chance to learn it.

At Fujita Health, a medical university that ranks in the 151-200 band in the Times Higher Education Japan University Rankings, international exchanges will be restored as soon as Covid permits.

Demographic change

Demographic changes in Japan have a profound impact on all areas of Japanese society, including higher education.

In January, government figures said the number of Japanese citizens aged 20 had fallen to around 1.2 million, down 40,000 from the previous year and the lowest since the survey began in 1968.

The number of children aged 14 or younger is also down, with 14.9 million recorded in 2021, down 190,000 from the previous year. This brought the proportion of children in the overall population to its lowest point, 11.9%, after 47 consecutive years of decline. This is the lowest proportion of children among the 33 countries with more than 40 million inhabitants, below South Korea’s 12.2% and Italy’s 13.3%, according to the United Nations. Demographic Directory.

Yuzawa worries about the impact this will have on teaching standards, saying universities are admitting less able students to fill their places. It will only get worse, he believes.

He acknowledges that universities need to do more to upgrade less able students, and adds that structural changes are also happening. Departments and resources are being merged into universities to meet declining demand levels.

Meanwhile, university leaders have been given more autonomy to make changes to their institutions – a change which Yuzawa, perhaps unsurprisingly, sees as a good thing and which will allow presidents to guide their universities in developing new areas of research and study.

“We need to restructure the universities. Every school should be structured according to the changes in society,” he says. If Japanese universities don’t refocus on the latest research areas, such as big data, he fears they will fall behind higher education institutions in the rest of the world.

As a trained physician and medical scholar, Yuzawa believes changes are also needed in medical education. Before becoming president of Fujita Health, he ran a hospital and he feels that there is not enough crossover between clinical practitioners and research. In Japan, there are excellent medical researchers and excellent doctors, but the country lacks doctors who also do research, he said.

“This type of doctor is very important for us to promote advanced medical care,” he explains, adding that he admires the British and American system of doctors taking sabbaticals for research.

Fujita Health University hosts the THE Asian Universities Summit this week, where delegates will explore how Asian universities need to adapt and provide learning opportunities that will upskill people in the societies they serve.

Yuzawa thinks lifelong learning will be very important, but he thinks Japanese society will have to adapt to embrace it. Japanese companies tend to provide stable jobs for life, which reduces the need for upskilling, he says.

Medical school scandal

In 2018, Japanese academia was shocked when a government investigation revealed that medical schools had manipulated admissions to exclude female students, apparently out of fear that they would continue to practice medicine.

Fujita Health was not one of nine universities deemed to discriminate against women, but as a member of the medical community, what impact has the scandal had? Things have “changed drastically,” says Yuzawa. Medical schools must now publish entry rates by gender, and data shows they are now roughly equal.

And what about the larger problem of women who study but do not pursue a career in medicine? “Japanese husbands usually don’t help,” he says.

Yuzawa’s younger colleague, who is present at the interview to help interpret if necessary, chimes in: “You’d be surprised how useless husbands are in Japan. At home, they just sit and watch TV – and everything, like cooking, taking care of the children, that’s what mothers do,” she says.

The culture is changing with the younger generation, however, Yuzawa and his colleague agree. Yuzawa thinks the roles of doctors also need to change as they are too demanding for someone to have a family at the same time.

Medicine is also changing and Yuzawa’s eyes light up when he describes the developments he is passionate about: big data, stem cell-based organ regenerative therapy and robotic surgery are some of the fields, as well as new drugs that can “completely cure all types of cancer”.

Yuzawa went into medicine, he says, because it combines lifelong learning with caring for others. “Medicine is a rewarding profession to pursue throughout one’s life.”


Fast facts

Born: Nagano prefecture on the island of Honshu, 1968

Academic Qualifications: MD and PhD from Nagoya University School of Medicine

Lives with: Only


This is part of our “Talking leadership” series of 50 interviews over 50 weeks with leaders from the world’s top universities on how they solve common strategic problems and implement change. Follow the series here.

The THE Asia Universities Summit, in partnership with Fujita Health University, runs from May 31 to June 2.

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