Graduate medical students have been expected to have different characteristics and backgrounds. If it is true, our strategy to educate them should be differentiated. However, basic medical education for graduate entrants in Korea now is not much different from those for non-graduate entrants. Therefore, I investigated the differences between graduate entry and schoolleaver students. Herein, I reviewed their demographics, academic backgrounds, career choice motivation, moral reasoning ability, learning styles and strategy, academic achievement, quality of school life, and outcome after graduation. Also I tried to suggest the differentiated strategy for effective education according to curriculum, teaching and learning, assessment, student support system, and admission selection policy.
Achievement ; Career Choice ; Curriculum ; Demography ; Education, Medical ; Education, Medical, Graduate ; Humans ; Korea ; Learning ; Motivation ; Schools, Medical ; Students, Medical

PURPOSE: The aim of the study is to evaluate the possibility of giving student interns intern- level responsibilities and to discuss the various obstacles. METHODS: Modifications were made to the student internship program, including rotations through major departments, for 4th-year medical students and was conducted at the College of Medicine, Kangwon National University. We surveyed 49 students for the evaluation of the program, administered a checklist evaluation for their performance, and interviewed two focus groups of faculties and residents to find out the obstacles of the program. RESULTS: Most of the students answered that the program was satisfactory and necessary. Of the students, 71.4% performed as an acting intern. The mean score of the students' performance was 84.1. The students had the most difficulty with time management and making diagnostic and management decisions. Initially, at the start of the program, both students and residents were somewhat confused about the student interns' duties. They suggested that definite learning objectives, legal and institutional support to students' clinical practice, and announcements to patients and hospital staff should be put in place prior to the implementation of such a program. CONCLUSION: We discovered that it was possible for student interns to perform at the level of interns. We suggest that systemic improvements continue for the establishment of such student internship program.
Checklist ; Education, Medical ; Focus Groups ; Gangwon-do ; Humans ; Internship and Residency* ; Learning ; Students, Medical ; Time Management

PURPOSE: Ethics objective structured clinical examination (OSCE) scenarios was developed and were applied to medical students to see whether it would be suitable for assessing the students' ethical behaviors. METHODS: The data for this study were gathered from the end-of-clerkship patient-doctor-society OSCE, involving third-year medical students along the academic year of 2006. 54 students who participated in the ethics OSCE, which consisted of three stations, responded. Nine standardized patients (SPs) participated in the evaluation. The SPs were trained for 4 hours to conduct the medical interview and for 2 hours for evaluating students' performance using the checklist for each station. RESULTS: The consistency (Cronbach's alpha) of the SPs was 0.796. Mean score was 57.33. There was no difference among circuits and gender. CONCLUSION: We found that the ethics OSCE was adequate for evaluating students' performances.
Checklist ; Ethics, Medical ; Humans ; Students, Medical

PURPOSE: The aim of this study is to evaluate the students' clinical competency from the patient safety perspective. METHODS: We conducted this evaluation in 2006 at College of Medicine, Kangwon National University. We surveyed 50 fourth-year medical students after finishing all clinical clerkships. 49 Students evaluated their achievement with 5-Likert score scale. The questionnaires were composed 6 domains: communication skills, prevention & management of adverse events, using evidence and information techniques, teamwork & leadership, medical ethical behaviors, and procedural skills. The each domains were constituted several items. Total 53 items was evaluated. RESULTS: The students' preparedness was relatively low in 28 items of the total 53(difficult communication, detecting and managing medical errors, using evidence and information technique, understanding of complex systems, autonomy, and procedural skills). CONCLUSION: The items with low achievement were closely related with medical errors and patient safety. These findings suggest that the clinical education is insufficient for preventing medical errors by students. For patient safety, we should understand the importance of achievement of competency related with patient safety and establish a systematic clinical curriculum with explicit learning outcomes.
Clinical Clerkship ; Curriculum ; Education ; Gangwon-do ; Humans ; Leadership ; Learning ; Medical Errors ; Patient Safety* ; Students, Medical ; Surveys and Questionnaires

PURPOSE: The purpose of this paper was to assess if there is a relationship between Kolb learning styles and learner variables including age, gender, and grade retention among medical students. METHODS: The Kolb Learning Style Inventory(LSI) is used at many educational levels to determine the learning preferences of medical students and clinicians. The students' learning styles were analyzed for associations with learner variables. The Kolb LSI was administered to 164 Kangwon medical students. They were categorized based on learner variables. RESULTS: Kolb's 'assimilator' was the preferred learning style type of the study group(55.2%). 'Accommodator'(17.8%) and 'diverger'(16.0%) were next, followed by 'converger'(11.0%). Learning style preferences of medical students did not vary significantly according to age, gender, and grade retention. CONCLUSION: No statistically significant relationships were identified between the Kolb learning styles and learner variables. The assessment of medical students' learning styles categorized based on Kolb LSI is expected to provide educators with skills to plan teaching strategies, employ a variety of teaching methods, and facilitate academic performance.
Gangwon-do ; Humans ; Learning* ; Students, Medical ; Teaching

PURPOSE: Despite radical lymph node dissection and combined resection, the operative results of treating advanced gastric cancer remains inadequate. The aim of this study was to determine the risk factors for recurrence of gastric cancer and the pattern of recurrence after curative resection for advanced gastric cancer. METHODS: Out of 220 patients who underwent curative resection for advanced gastric cancer from 1990 to 2000, 50 whose recurrence was confirmed by clinical, radiological, endoscopic or reoperative findings were studied retrospectively. We undertook a detailed analysis of the pattern of recurrence based on the morphologic and histopathologic characteristics of the initial tumor. RESULTS: The mean time to recurrence was 19.0 months. Early recurrence was found in 38 patients (76.0%), intermediate recurrence was found in 11 patients (22.0%), and late recurrence was found in 1 patient (2.0%). The patterns of recurrence were as follows: hepatic recurrence was found in 14 cases, peritoneal recurrence in 19 cases, local recurrence in 10 cases, extraperitoneal recurrence in 6 cases. In univariate analysis, the depth of invasion, extent of lymph node metastasis, TNM stage, and combined resection were important for recurrence. In multivariate analysis, depth of invasion and lymph node metastasis were important for recurrence. CONCLUSION: The peritoneal recurrence was the most frequently encountered pattern of recurrence. The two years following surgery was the most important period for recurrence. Depth of invasion and lymph node metastasis were related to recurrence with statistical significance. Since the results of treatment remain dismal, studies of perioperative adjuvant therapy in an attempt to reduce recurrence are warranted.
Humans ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms*

BACKGROUND/AIMS: The c-met proto-oncogene encodes the tyrosine kinase receptor for hepatocyte growth factor (HGF), a potent mitogen and motogen for epithelial cells. Because of its profound effects on cell growth and motility, HGF may be important in the development of cancer metastases in hepatocellular carcinoma (HCC). We examined the expression of the c-met proto-oncogene product (c-Met) in the patients with HCCs to determine the relationship between the level of expression of c-Met and clinicopathological features, and patient outcome following hepatectomy. METHODS: Fifty patients with surgically resected hepatocellular carcinoma at Seoul National University Hospital from January 1997 to December 1998 were included in this study. Western blotting was used to examine the c-Met expression of tumor and surrounding tissues. The clinicopathologic features and treatment results of the patients were analyzed by medical records. Patients were divided into two groups, low c-met HCC and high c-met HCC. RESULTS: c-Met was not overexpressed in HCC compared to surrounding tissue. The expression of c- Met in tumor tissue was correlated with well-differentiated HCCs, and adversely correlated with tumor necrosis by transcatheter arterial chemoembolization (TACE). There was no correlation between c-Met expression and intrahepatic recurrence. CONCLUSION: In conclusion, these results indicate that c-Met expression in HCC is not correlated with intrahepatic recurrence, and tumor necrosis by TACE reduces c-Met expression in tumor tissue. More large-scaled study is needed for exact relation between c-Met expression and clinicopathologic features of HCCs.
Blotting, Western ; Carcinoma, Hepatocellular* ; Epithelial Cells ; Hepatectomy ; Hepatocyte Growth Factor ; Humans ; Medical Records ; Necrosis ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Recurrence ; Seoul

BACKGROUND: Intraductal papillary mucinous tumor (IPMT) of the pancreas is a rare tumor arising in the main pancreatic duct or its subbranches. It is characterized by a diffusely or focally dilated main pancreatic duct filled with mucus and a mucus secretion through a patulous duodenal papilla. METHODS: The clinicopathologic characteristics of eight IPMT cases which were resected surgically from January 1994 to August 1998 at Seoul National University Hospital were reviewed to consider the optimal surgical treatment. RESULTS: The range of ages was from 49 to 70 years with a mean age of 59.3. Five were men and three were women. The prominent symptom was upper abdominal pain. Seven patients had been treated for pancreatitis before. Tumor markers didn't correlate with the pathologic status. In all the cases, a dilated pancreatic duct with secretion of mucin was found in the radiologic studies. Four lesions were located in the uncinate process, 3 in the body, and 1 diffusely. One total pancreatectomy, 1 Whipple's procedure, 3 pylorus-preserving pancreatoduodenectomies, 1 duodenum-preserving resection of the head of the pancreas, and 2 subtotal pancreatectomies were performed. Three lesions were malignant, another three were borderline malignant, and the remaining two were benign. Three were multiple lesions. Lesions for which the main pancreatic duct was dilated more than 0.5 cm, lesions greater than 2.5 cm, lesions with a mural nodule greater than 1.0 cm, or type 1, 2, 3 lesions were borderline malignant or malignant. There was no lymphatic metastasis. After a follow-up duration from 1 month to 56months, all patients are alive at the time of study and have experienced no locoregional recurrence or distant metastasis. CONCLUSIONS: In the radiologic studies, an IPMT should be considered in a multilobulating cystic lesion with the dilated main pancreatic duct. The lesions are variable from benign to malignant and often spread intraductally. When the lesion seems to be malignant, an aggressive resection is recommended.
Abdominal Pain ; Biomarkers, Tumor ; Female ; Follow-Up Studies ; Head ; Humans ; Lymphatic Metastasis ; Male ; Mucins* ; Mucus ; Neoplasm Metastasis ; Pancreas* ; Pancreatectomy ; Pancreatic Ducts ; Pancreaticoduodenectomy ; Pancreatitis ; Recurrence ; Seoul

PURPOSE: To draw attention to patient safety and increase its awareness among medical students, we developed a program that teaches patient safety based on common medical error cases. The aim of this study is to introduce this program and improve student receptivity to it. METHODS: As part of the "Patient, Doctor, and Society" course, third-year medical students participated in 8 hours of a medical error education program. Students discussed recent, typical medical lawsuits that were generated from internal medicine, surgery, pediatrics, obstetrics and gynecology, neurosurgery, medication, anesthesia, and blood transfusion cases. Students weighed these issues in small groups, using various discussion methods. After finishing the program, students completed a course evaluation questionnaire. RESULTS: The students rated this program as satisfactory, highly motivating, and helpful in preparing their future practices. They responded that although the cases were interesting, some were difficult. They stated that the small group discussion techniques encouraged them to take active part in the discussion and to consider the cases more deeply. CONCLUSION: Small group discussion of medical error cases is an effective method for students to study patient safety.
Anesthesia ; Blood Transfusion ; Group Processes ; Gynecology ; Humans ; Internal Medicine ; Malpractice ; Medical Errors ; Neurosurgery ; Obstetrics ; Patient Safety ; Pediatrics ; Safety Management ; Students, Medical ; Surveys and Questionnaires

PURPOSE: The surgery clerkship, focusing on the clinical competency, including critical thinking, problem solving, self-directed learning, autonomy and professionalism, were revised. The purposes of this study were to evaluate the students' assessment of the revised surgery clerkship program in order to improve the quality of surgical education. METHODS: Clinical competency was classified into 6 dimensions: intelligence, skill, relationship, attitude, problem solving performance, and autonomy. Problem based learning (PBL), procedural skill training, surgical anatomy, case discussion, pre-diagnosis at outpatient clinics, quiz, clinical performance assessment (CPA) and modified essay question (MEQ) were performed. Forty-nine 3rd year medical students participated during 2002. All students were asked to rate how far they had progressed in the 6 dimensions, in order to evaluate the course, and each program, and to suggest improvements at the end of the rotation. RESULTS: The students responded extremely positively and became been more motivated. They evaluated that the new clerkship had helped them increase their abilities in clinical reasoning, self-directed learning, problem solving and clinical techology, and to develop professionalism and autonomy. Most of students revealed that the PBL, case discussion, pre-diagnosis at outpatient clinics, CPA and MEQ programs were very helpful. They felt that procedural skill training and surgical anatomy programs required further improvements. CONCLUSION: The implementation of the new surgery clerkship was successful. The PBL, case discussion, pre-diagnosis at outpatient clinics, CPA and MEQ were valuable learning tools. More tools should be developed for procedural skill training and surgical anatomy education.
Ambulatory Care Facilities ; Education ; Humans ; Intelligence ; Learning ; Problem Solving ; Problem-Based Learning ; Students, Medical ; Thinking