Since prevention of prescription error with understanding drug actions should be one of pragmatic outcomes for all medical students, curriculum of pharmacology and clinical pharmacology at medical school should be integrated to achieve this purpose. There are, however, very few clinical pharmacologists in Japan. Drugs are prescribed by nearly all doctors, most would see themselves as practicing clinical pharmacology & therapeutics every day. Clinical pharmacology, even if with strong clinical background, has looked weak as a specialty without an organ or a disease. Clinical pharmacologists/pharmacologist used to have a close relationship with research into, and management of chronic common diseases such as cardiovascular diseases, which has increasingly devoted to specialists or primary care. More importantly, the shift from pharmacology(theory)-based medicine to evidence based medicine after the CAST trial has effect curriculum of medical schools.
　We should not, however, be too pessimistic. Current problem regarding drug therapy such as polypharmacy and potential inappropriate prescription may be handled by clinical pharmacologists rather than specialists. Development of functional biomarkers based on pharmacological action to describe patients who will benefit from new drugs may lead to precision medicine.