We propose to utilize the change in each junior doctor’s examination score from the first year to the second year of the resident program to evaluate the causal impact of elite hospital training on junior doctors’ quality growth.  This project will be the first that links nationwide examination results of Japanese junior doctors to their training programs. For this project, we will also evaluate examination designs and question quality. Such evaluation of national medical examinations will also be the first time in Japan. Our results outcomes will potentially make important contributions to the academic literature and provide useful policy implications.  We intend to first work closely with policymakers and official data management officers in evaluating and improving the designs of national examinations. Using the evaluation results and the data sources, we can go further to examine the effectiveness of hospital training programs in improving junior doctors’ performance. Our findings will potentially help policymaking and contribute to academic literature.