In Japan, public trust towards its hospitals was waning.

Medical mishaps and incidents had increased 2.5 fold in the last decade.

Traditional examinations for surgeons in Japan included only written tests and interviews.

For many years, this academic-centric approach had not changed.

That is, they could become doctors only with medial knowledge.

Kurashiki Central Hospital, one of the Japan's largest, also operated under these standards.

For the betterment of the medical profession, a new paradigm was needed, and fast.