Dear Members:

The 114^th annual meeting of the Oto-Rhino-Laryngological (ORL) Society of Japan, Inc., was held in Sapporo, Hokkaido. When the annual meeting was held in Sapporo 15 years ago, lilacs were in full bloom along "Odori" Park. This year, the temperature was so low that the cherry blossoms had only just reached full bloom. At the latest annual meeting in Niigata, detailed explanation and guidance for business meetings were essential for the members and representatives in order to fully understand the proceedings. It is because that annual meeting in Sapporo was the first gathering after the ORL Society of Japan became a general incorporated association. In comparison, everything looked very smooth at this year's annual meeting, because we have become accustomed to the new system.
The most critical issue to be discussed among plenty of issues was a revision of the board-certified otorhinolaryngologists' regulations, which has a big impact on the future direction of the ORL Society of Japan, Inc. As you know, the board of directors and the committee for the board certification system have spent a great deal of time and effort on this matter, and then we have disclosed the content of our deliberations to the members on our website, in advance. As I have mentioned earlier, the newly revised system should be confirmed in order to upgrade the quality of board-certified otorhinolaryngologists.
The Ministry of Health, Labour and Welfare launched the "Investigative commission related to the state of board-certified doctors" in 2011 and the commission delivered its final report on April 22nd, 2013. The direction in that report and ours clicked together, therefore it helped us to draw conclusions at the annual meeting. I would like to briefly introduce the content of this final report to you. In the 2013 fiscal year, a new organization independent from each society will be established and this organization will take the leadership in introducing new training systems for board-certified doctors in all areas of medical care.
The revision of the board-certified otorhinolaryngologists' regulations will be accomplished to guarantee addressing the high quality of board-certified doctors equipped with a high standard of otorhinolaryngological medical care. Our responsibilities could be summarized with four tasks as follows; 1) construct a group of hospitals composed of a main training hospital and related facilities, 2) create specific training programs for the period of more than four years, 3) certify the training facilities of the hospital groups; and 4) certify instructors.
As explained more concretely in the following, trainees (doctors who undergo the training program to become board-certified otorhinolaryngologists) have to go through the programs with a certain number of cases, respectively, to perform surgeries, take care of patients, and to address academic presentations together with writing articles during the period of 4 years and more, at the facilities mainly composed of university hospitals and their related hospitals. Needless to say, the purpose of this training program is to master the enough skills to provide the standard ORL medical services to patients. The new system will begin in 2017 in all field of basic medical care. So, the program should be well designed and prepared by 2015. I would like you all to cooperate with us to improve the quality of board-certified otorhinolaryngologists.

As you already know, the accounting system of the ORL Society of Japan, Inc., as a general incorporated association, is integrated with the regional societies' accountings, in order to maintain the system of the ORL Society of Japan, Inc., having been cooperative with the regional societies. We have been recently asking each regional society of the ORL to move up the report of budget-making and settlement of accounts.
Of course, we can imagine that regional societies have been recently going through a lot of difficulties to overcome their burden. Nevertheless, it is a heavy burden to manage the accounts of the ORL Society of Japan, Inc. As I commented on it at the annual meeting, the ORL Society of Japan's financial situation has recently become very tough and the finances actually fell into a deficit on a single-year basis for the past several years, even though we have been trying to cut down on expenditure. Furthermore, we can never expect any significant improvement of our finances in the near future. Therefore, we are obliged to precisely calculate our financial balance, and then we would like you to consider the possible raising of annual membership due at the next 115^th meeting in Fukuoka.
In all of the above, I have informed you of two main issues: firstly, the accounting system of the ORL Society of Japan, Inc. and its financial situation ; and secondly, the revision of the board-certified otorhinolaryngologists' regulations and its background.
Finally, I would like to promise you that the board of directors and various committees will overcome a number of problems and accomplish various undertakings during their appointed residual period of time.
Hopefully, all our members understand our situation and support us very much.

Sincerely yours,

Toshiaki Yagi, MD,
Chairman, Board of Directors
The Oto-Rhino-Laryngological Society of Japan, Inc.

(May 30^th, 2013)