TSUKASA OBAYASHI, Nikkei senior staff writer

TOKYO — For what appears to be the first time, the acceptance rate for women has exceeded that for men at Japanese medical schools.

Among male applicants for medical programs at national, public and private universities, the overall acceptance rate was 13.51%, lower than the 13.6% for women, according to data from the Ministry of Education, Culture, Sports, Science and Technology.

The share of universities reporting lower acceptance rates for women than men dropped drastically to 44% in fiscal 2021 from 67% the year before.

This marks a watershed moment in Japan’s medical education history. Despite the growing ranks of aspiring female physicians, medical schools had long remained skeptical about women balancing work and family life as doctors.

Tokyo Medical University’s practice of inflating entrance exam scores for the sons of Education Ministry bureaucrats came to light in 2018, and similar score manipulation practices at other medical universities were reported. In many cases, schools limited the admission of women and those who failed the exam many times in the past by giving their essays low marks.

Facing public outrage, the Education Ministry released gender breakdowns of those accepted to all college medical schools from fiscal 2013 through fiscal 2018. The plan after that was to release the breakdowns for universities that had admitted to score manipulation, but lawmakers argued successfully for releasing all data from fiscal 2019 and onward.

Male applicants were favored in fiscal 2019, 12.11% to 11.37%, and the gap widened slightly in fiscal 2020 to 12.56% versus 11.42%. The reversal for fiscal 2021 is the first in the ministry’s data and, according to many experts, probably the first ever.

The continued disclosures appear to helped push schools toward fairer admissions practices.

Japanese Medical and Dental Practitioners for the Improvement of Medical Care, a group of more than 100,000 medical professionals, responded to the news with a statement urging Japanese medical schools to ensure entrance exams remain fair.

“They should disclose gender breakdowns by section, such as written and oral tests,” said an official at the organization.

Medical schools are highly competitive, but it is not clear that they have kept up with a fast-changing economy and society. Advances in medical technology, digitalization, changing treatment needs that come with longer lifespans, and pressure on government health care funding are all transforming the landscape. Gender equity in admissions is just one step toward reform.

Work reform will be one key to maintaining a level playing field.

The government in 2019 imposed a strict cap of 720 hours of overtime per year on the medical sector, with penalties for violators. But this came with a five-year grace period for institutions in outlying areas that could be negatively affected by the restriction.

A survey of young doctors who completed their clinical training suggests that women tend to steer clear of specialties that often involve long hours and shifts at night or in the early morning. Schools that manipulated scores to admit fewer women may have used such trends to justify their decision.

While this does not excuse their actions, it is true that when students can freely choose their preferred field, admitting more women could make it harder for schools to maintain a steady number of surgeons at their affiliated hospitals.

This situation underscores the need for more thorough work reform to give female doctors more opportunities to succeed, but it also exposes more fundamental problems with the current system.