The 2010 announcement by the Education Commission for Foreign Medical Graduates, related to accreditation by the World Federation for Medical Education, accelerated medical education reform in Japan. This article reviews reports on reforms undertaken in undergraduate medical education in psychiatry in Japan after 2010, and discusses resulting implications. While Japanese medical education has made significant progress, achieving global standards in less than a decade, there remain issues related to utilisation of active learning - inclusion of self-directed learning, problem-based learning, team-based and small group learning, and clinical training - as well as the provision of opportunities for students to be involved in certain medical procedures, and the integration of behavioural and social sciences, including communication skills, decision making, medical ethics, medical psychology, and general health promotion perspectives. These issues imply considerable paradigm shifts for psychiatry in Japan. It remains to be seen whether these progressive perspectives in undergraduate education can be effectively incorporated into postgraduate training, as well. There is also an issue of balance with specific important areas. The question of how undergraduate education in psychiatry in Japan can assimilate issues relevant to the practice of psychiatry in Japan, while ensuring conformity with high-level global standards, remains a serious challenge.