Physicians working in hospital-based medicine continue to face demanding conditions. At Hyogo Prefectural Amagasaki General Medical Centre, about 30 doctors work in the cardiology department, treating patients with heart disease and responding to emergency cases around the clock. Doctors there handle both hospitalised patients and emergency arrivals 24 hours a day, 365 days a year, often working overnight shifts about six times a month. Because cardiovascular treatment requires teamwork, multiple physicians must coordinate closely to treat each patient. With limited staff, the workload placed on each doctor can become overwhelming. Some physicians say that once working hours stretch too far, even higher salaries cannot compensate for the loss of time with their families. Becoming a doctor in Japan requires graduating from medical school, passing the national medical licensing exam, and completing two years of initial residency across multiple specialities. Afterwards, physicians typically choose a speciality such as internal medicine or surgery and undergo further training. In recent years, however, more doctors have chosen to enter cosmetic medicine immediately after their initial residency. According to the Ministry of Health, Labour and Welfare, the number of such doctors has increased roughly tenfold over the past decade.