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On March 10 and 11, 2005, 20 prominent Japanese physicians and nurses from 13 well known universities and tertiary care hospitals ( St Mariana University, Tokyo University, Keio University, Tohoku University, Gifu University, Teikyo University, Dokkyo University and Kyorin University; International Medical Center, St Luke's International Hospital, Toranomon Hospital, Funabashi Municipal Hospital and Red Cross Hospital ) visited the Center for Emergency Medicine and WISER. This visit was sponsored by the Pittsburgh Japan EM Prehospital Care Program and Laerdal Medical Japan KK. In Japan, medical education has recently been reorganized. A matching system for the residencies was introduced in 2004. Simulation training is now under consideration for implementation in the near future.