[논문]우리나라 의학의 현실과 미래: 교육, 연구, 진료를 중심으로

정대철

doi:10.17496/kmer.2019.21.2.73

우리나라 의학의 현실과 미래: 교육, 연구, 진료를 중심으로
The Current and Future State of Academic Medicine in Korea: Education, Research, and Patient Care 원문보기

의학교육논단 = Korean medical education review, v.21 no.2, 2019년, pp.73 - 79

Abstract ▼ AI-Helper

Academic medicine is built from a foundation of education, research, and patient care. Since good patient care results from the application of medical research and continuous education, these three components cannot be separated for medical development to occur. In Korea, many obstacles hinder the achievement of academic medicine, such as an inefficient medical delivery system, limitations of primary care, low insurance prices, and no long-term health care plan. Medical education has changed to outcome-based education, but presented temporal integration status. Governance of healthcare research is not centralized, and Korea is awarded relatively fewer grants than other countries. Medical professors have reached a burnout state due to patient care responsibilities in addition to research and education duties. Many medical systems, including the medical delivery system and insurance problems, may contribute to distrust between doctors and patients. The government is not involved in a long-term health care policy. The multitude of factors mentioned here are hindering the achievement of academic medicine in Korea.

주제어

표/그림 (3)

그림 Figure 1. Medical price share by hospital type per year.
표 Table 1. Outpatient clinic visitation per person by country (number of visits per person)
표 Table 2. Ratio of medical cost per person by GDP and household expenditure

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

앞에서 우리나라 의학계에 대해 간단히 서술하였으며, 4차 산업혁명이 도래하는 이 시기에 우리나라 의학이 어떻게 대처하고 체계화해야 할지 현재 우리나라 의학계에 복잡하게 얽혀있는 여러 상황과 문제점에 대하여 정리해보았다. 의학이 발전하려면 국가의 의료정책에 기반을 두어야 하며, 교육, 연구, 진료가 일체가 되어 증진효과(synergistic effect)를 보여야 한다.
우리나라 의학교육은 20세기부터 시작되어 현재 40개의 의과대학에서 교육을 하고 있으며, 국가 정책과 맞물려 의료가 이루어지고 있다. 이번 연구에서는 현재 우리나라 의학의 현실을 교육, 연구, 진료 측면에서 돌아보고, 의학발전을 위해 개선하여야 할 문제와 방향을 제시함으로써 미래 한국의학이 나아갈 방향을 알아보고자 한다.

성능/효과

이로 인하여 많은 교수들은 탈진되어 가고 있다[22]. 교수들의 탈진은 냉소주의와 성취감 결여가 중등도였고, 근무시간이 많을수록, 통계적 의의는 없지만 나이가 많을수록 탈진은 매우 현저하게 나타났다. 또한 의과대학 교수로서 가장 힘든 일은 연구이며, 시간을 많이 보내는 일은 진료였고, 냉소주의 탈진은 교육에 대한 내용이었다[22].
다섯째, 보건의료는 개인에 의한 것보다 공익성이 중요하다. 국민들의 건강과 의학발전을 위해서는 국가의 의학교육에 대한 투자가 있어야 한다.

후속연구

넷째, 국민의 건강과 관련된 보건의료 관련 연구에 대한 일관성 있고 체계적인 국가적 추진체계가 필요하다. 미국이나 일본과 같이 미래지향적인 보건의료 관련 연구를 주관하는 기관이 있어야 한다.

참고문헌 (44)

Park MC, Lee MP, Kang SJ. History of medicine. Seoul: Big Book; 2018.
Bowels MD, Dawson VP. Part I: establishing medical education standards, 1876-1957. In: Bowels MD, Dawson VP, editors. With one voice: the Association of American Medical Colleges, 1876-2002. Washington (DC): Association of American Medical Colleges; 2003. p. 17-66.
Kanter SL. What is academic medicine? Acad Med. 2008;83(3):205-6.

상세보기
Association of American Medical Colleges. Academic medicine: where patients turn for hope [Internet]. Washington (DC): Association of American Medical Colleges [cited 2019 Apr 27]. Available from: https://members.aamc.org/eweb/upload/Academic%20Medicine%20Where%20Patients%20Turn%20for%20Hope.pdf.
General Medical Council. Our role and the Medical Act 1983 [Internet]. London: General Medical Council [cited 2019 Apr 27]. Available from: https://www.gmc-uk.org/about/what-we-do-and-why/our-mandate.
Schwab K. The fourth industrial revolution. Song GJ, translator. Seoul: MegaStudy Co. Ltd.; 2016. 287 p.
Seo JB. The role of medical doctor in the era of artificial intelligence. J Korean Med Assoc. 2019;62(3):136-9.

상세보기
Chang SG. The fourth industrial revolution and changes in the future medical world. J Korean Med Assoc. 2017;60(11):856-8.

상세보기
Britnell M. In search of the perfect health system. Seoul: The Korean Doctors' Weekly; 2016.
Kim KH, Lee JC, Seo KH, Kim SY, Lee JS. Analysis and proposal for improvement about health care delivery system. Seoul: Research institute for health care policy, Korean Medical Association; 2015.
Song GY. Improvement of medical system. J Korean Hos Assoc. 2004;33(1):37-48.
Kim Y. Healthcare policy and healthcare utilization behavior to improve hospital infection control after Middle East respiratory syndrome outbreak. J Korean Med Assoc. 2015;58(7):598-605.

상세보기
Kang HJ, Oh YS, Baek HY, Ha SY, Kim SU, Seo EW, et al. Assessment of the innovation outcome in the Korea health care system: 2017 Korea healthcare quality report. Sejong: Korean Institute for Health and Social Affairs; 2017.
Cho HH. Problem and its improvement for medical healthcare delivery system. Med Policy Forum. 2016;14(2):45-50.
Oh KA. Why patients were crowded to big hospital. Joongang Ilbo. 2014 Jun 9.
Kim MK, Kim KH, Kim HN, Lee JC. Survey for people's usage of medical institute according to national health insurance coverage extension plan. Seoul: Research Institute for Healthcare Policy, Korean Medical Association; 2018.
Health Insurance Review and Assessment Service. 2017 HIRA national health insurance expenditure trends report. Wonju: Health Insurance Review and Assessment Service; 2018. 76 p.
Kim BS, Yang EB, Jeong DC, Chung SS, Hur YB, Kang SH, et al. A study on the concept of academic medicine and countermeasures for medical education in the era of the fourth industrial revolution. Seoul: Research Institute for Healthcare Policy, Korean Medical Association; 2019.
Shin JS. Competent doctor is not coming from sky. Kyunghyang Newspaper. 2016 May 31.
Han JJ. Current issues and future considerations in undergraduate medical education from the perspective of the Korean medical doctor development system. Korean Med Edu Rev. 2018;20(2):72-7.
Yand EB, Cho MJ, Lee SG, Kim JY, Kim SY, Lee KH, et al. Current status of medical professors and study for professor achievement system. Seoul: Korean Association of Medical Colleges; 2018.
Seo JH, Kim B, Bae HO, Im SJ, Kim KH. Burnout among medical school faculty members: incidence and demographic characteristics at three medical schools in the Busan and Gyeongnam area of Korea. Korean Med Edu Rev. 2014;16(2):67-76.

원문보기 상세보기
Research Institute for Healthcare Policy. 2016 Korean Physician Survey. Seoul: Research Institute for Healthcare Policy, Korean Medical Association; 2017.
Jung SM. Current status and directions of resident education. J Korean Med Assoc. 2019;62(2):72-7.

상세보기
Han JJ. Challenges and progress of clinical education in Korea. J Korean Med Assoc. 2012;55(10):926-8.

상세보기
Kang SH, Cho HS, Kim DH, Kwon HJ, Chung JW. Medical education improvement plan for reinforcing primary care. Seoul: Research Institute for Healthcare Policy, Korean Medical Association; 2017.
Yoon SJ. Rapid growth of urban big hospital and present status of primary clinics. Med Policy Forum. 2013;10(4):15-20.
Kim JY. Status of national R&D grants for health care. KHDI Brief. 2014;129:1-8.
Park EJ, Kim JS, Yoon SM, Yoon HW, Lee YS, Kwak NS, et al. Study on the R&D systems in health care. Sejong: Korean Institute for Health and Social Affairs; 2013.
Japan Agency for Medical Research and Development. Objectives and main projects covered by AMED [Internet]. Tokyo: Japan Agency for Medical Research and Development; 2019 [cited 2019 Feb 8]. Available from: https://www.amed.go.jp/en/aboutus/objectives_project.html.
National Institute of Food and Drug Safety Evaluation. Clinical trial in Korea [Internet]. Cheongju: National Institute of Food and Drug Safety Evaluation [cited 2019 May 3]. Available from: http://www.nifds.go.kr/brd/m_244/list.do#none.
Min HS. Status and problems for Korea clinical trials: volunteer. Seoul: People's Health Institute; 2016.
Lee YH, Kang YJ, Yoon TY, Lee YM, Chae SJ, Hur YB. Study for improvement of Korean doctor national examination system. Seoul: Korean Health Personnel Licensing Examination Institute; 2018.
Kim MK, Lee PS, Lee E. Trends and suggestion for management system of foreign doctor in the view of medical professionalism and self-regulation. Korean J Med Ethics. 2016;19(4):430-46.
Korean Association of Medical College. Learning outcomes of basic medical education: scientific concept-and principle centered. Seoul: Hwasan-Munwha Press Co.; 2014.
Korean Association of Medical College. Learning outcomes of basic medical education: clinical competency-centered. 2nd ed. Paju: Gabwoo- Munwha Press Co.; 2016.
Korean Association of Medical College. Graduate outcomes of basic medical education. Seoul: Korean Association of Medical College; 2017.
Harden RM. The integration ladder: a tool for curriculum planning and evaluation. Med Educ. 2000;34(7):551-7.

상세보기
Kim YC. Improving the role of the teaching hospital in the clinical clerkship. Korean Med Edu Rev. 2015;17(1):10-4.

원문보기 상세보기
Kim JS. Status of health care and medical fee: USA, Canada, China, Russia. KHDI Brief. 2012;13:1-8.
Research Institute for Healthcare Policy. 2017 Handbook of health statistics. Seoul: Research Institute for Healthcare Policy, Korean Medical Association; 2017.
Lee HJ, Shin EC, Lee CW, Park SJ, Kang YJ, Im KJ, et al. Medical price levels of OECD countries: a comparative study. Seoul: Research Institute for Healthcare Policy, Korean Medical Association; 2013.
Lee HJ. Study of cost accounting result accuracy improving method study for policy about health insurance. Seoul: Yonsei Industrial-Academic Cooperation; 2016.
Yoon HS, Kim J. Activity-based costing analysis of nursing activities in general hospital wards. J Korean Acad Nurs Adm. 2013;19(4):449-61.

원문보기 상세보기

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증