The National Licensing Examination for Physicians (NLEP) is a public evaluation tool to determine the minimum professional competence of medical school graduates necessary to practice medicine in the community. Thus, it plays a critical role not only to determine the national standard of health care but also to give a great impact on the level of educational objectives in each medical school. Currently, the Korean NLEP system has been the target of public critics for last twenty years because of its lagging behind expected functions as a national parameter to assess the competencies of the applicants. This failure is largely related to the unrealistic and irrelevant system and ignorance of the changing health needs in the community. Among many other features the followings are the important characteristics of Korean NLEP system contributing to its failures ; (1) qualification and licensing are not separated and are under the control of a same government authority ; (2) Executive process of the examination is managed by the bureaucratic operational body with no adivice from expertees in educational evaluation and no integral coordination or machinary for educational feedback from medical school objectives ; (3) Test Committee remains under the governmental authority only as an advisory body and little opportunity for comprehensive planning or renovative effort ; (4) One day written examination with 340 multiple choice questions cover 5 major disciplines and 8 minors ; (5) Passing level is fixed at 60 percentile of the total scores minimum baseline scores no more than 40 percentile in every disciplines. Despite continuous efforts for better NLEP system and efficient operation since 1975, only a tip of improvement has been made in the administrative aspect of the examination in the present Korean setting. This article outlines a proposal for future renovative plan of Korean NLEP based on the previously identified issues and problems. Followings are the summary of recommendations. 1) Foundation of the National Board of Licensing Examinations for Physician, a semi-independent, non-profit organization, can solve the problems with regard to the educational irrelevance of the present system. Organizational remodelling of the existing Test Committee along with strengthening of the executive and planning functions may be the alternative. 2) Appropriate research and development on future renovative planning should be based on and integrated with medical school objectives and community needs. 3) Specific issues and related resolutional plans regarding roles of the testing body are proposed and discussed along with improvement of system itself and technical renovations. Included are feasibility on the establishment of discipline-based testing subcommittees, independency of qualification and licensing procedures, preview of applicants' quality and of educational institutions, and liaison with medical school dean's council. In addition, appropriate procedures to determine the disciplines to be tested, passing level, tables of specification, number of test items, item bank, automation, recruitment of expertees, improvement of test item construction, and test item analysis are stressed.
Automation ; Delivery of Health Care ; Licensure* ; Organizations, Nonprofit ; Professional Competence ; Schools, Medical

PURPOSE: The purpose of this study was to examine nursing students' attitude toward death and perception on hospice care. METHODS: The survey was performed with 277 nursing students in three universities in Daegu and Busan. The data was collected by questionnaires and were analyzed using descriptive statistics. RESULTS: Regarding the attitude on death, 93.9% of the subjects had ever thought about death. They worried about separation and sadness with family (39.7%). About half (48.7%) of the subjects considered death as a final process of the life. With regard to the perception of hospice, 93% of the subjects heard about hospice through books or nursing courses (83.8%). The best hospice management institution was considered the one run by religious groups or non-profit organizations with government support (33.9%). Ideal model of hospice setting in Korea was hospital or institution specialized with hospice care (47.7%). The barriers the subjects thought to effective hospice care in Korea was the lack of the public consensus on the need for hospice program (37.9%). The average perceptions about the purpose of hospice care was 4.38, whereas, the average of the need of hospice care was 4.06. CONCLUSION: The findings of the study provides the basis for expanding nursing practice and education related to hospice care.
Consensus ; Hospice Care ; Hospices ; Humans ; Korea ; Organizations, Nonprofit ; Surveys and Questionnaires ; Students, Nursing

Healthcare accreditation, which in the Republic of Korea is based on Article 58 of the Medical Service Act of July 2010, is an evaluation system designed to improve the quality of medical services and secure patient safety. Although ambulatory health organizations such as clinics comprise the majority of all health facilities, because they are not currently evaluated, securing quality and patient safety nationwide is not possible under the existing system. This article reviewed the accreditation programs of ambulatory health organizations in leading countries such as the United States and Australia in order to propose a successful model for Korea. The Accreditation Association for Ambulatory Health Care of the Unites States is a private, non-profit organization established in 1979. Similarly, Australian General Practice Accreditation Limited is a non-profit organization established in 1997 to deliver services to support general practices in Australia. Both are independent professional organizations and perform accreditation programs by a self-regulatory system. As healthcare quality improvement and accreditation have the characteristics of professional service activities, a self-regulatory approach rather than a government-controlled one, and process-oriented evaluation rather than structure-focused evaluation, are known to be effective. We expect an accreditation program for clinics in Korea to be established using a self-regulatory approach by an independent professional organization, not by the government, in the near future.
Accreditation* ; Ambulatory Care Facilities ; Australia ; Benchmarking* ; Delivery of Health Care* ; General Practice ; Health Facilities ; Korea ; Organizations, Nonprofit ; Patient Safety ; Quality Improvement ; Quality of Health Care ; Republic of Korea ; Societies ; United States

PURPOSE: Cancer clinical trials in Korea have rapidly progressed in terms of quantity and quality during the last decade. This study evaluates the current status of cancer clinical trials in Korea and their associated problems. MATERIALS AND METHODS: We analyzed the clinical trials approved by the Korea Food and Drug Administration (KFDA) between 2007 and 2013. A nationwide on-line survey containing 22 questions was also performed with several cooperative study groups and individual researchers in 56 academic hospitals. RESULTS: The number of cancer clinical trials approved by the KFDA increased almost twofold from 2007 to 2013. The number of sponsor-initiated clinical trials (SITs) increased by 50% and investigator-initiated clinical trials (IITs) increased by almost 640%. Three hundred and forty-four clinical trials were approved by the KFDA between 2012 and 2013. At the time of the on-line survey (August 2013), 646 SITs and 519 IITs were ongoing in all hospitals. Six high volume hospitals were each conducting more than 50 clinical trials, including both SITs and IITs. Fifty-six investigators (31%) complained of the difficulties in raising funds to conduct clinical trials. CONCLUSION: The number of cancer clinical trials in Korea rapidly increased from 2007 to 2013, as has the number of multicenter clinical trials and IITs run by cooperative study groups. Limited funding for IIT is a serious problem, and more financial support is needed both from government agencies and public donations from non-profit organizations.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Financial Management ; Financial Support ; Government Agencies ; Hospitals, High-Volume ; Humans ; Korea* ; Organizations, Nonprofit ; Research Personnel ; United States Food and Drug Administration

OBJECTIVETo investigate the survival and development conditions of community-based organizations (CBOs) for HIV/AIDS prevention and control among men who have sex with men (MSM) in Chinese cities including Shanghai, Hangzhou, Chongqing.

METHODSThis study employed both qualitative (focus groups) and quantitative (questionnaire survey) methods to obtain information from 15 MSM CBOs in three Chinese cities.

RESULTSThe mean work time of the 15 CBOs for HIV/AIDS prevention and control among MSM was 6.7 years (2.1-11.3 years), and the majority of their funds was from international cooperation projects (80 447 000 RMB, 73.0%) from 2006 to 2013. The survival cost of MSM CBOs apart from expenditure of activities was 2 240-435 360 RMB per year. As it was shown in the graph, the survival and development of MSM CBOs was closely related to the development of international cooperation projects. There was a few small size MSM CBOs taking part in the prevention and control of HIV/AIDS and their work content was limited before 2006. From 2006 to 2008, some international cooperation projects were launched in China, such as the China Global Fund AIDS project and the China-Gates Foundation HIV Prevention Cooperation program. As a result, the number of MSM CBOs was increased sharply, and both the scale and 2012, the performance of these programs further promote the establishment of new MSM CBOs and the development of all MSM CBOs with regard to the work places, full-time staffs, work contents, work patterns and the specific targeted population. After 2012, most international cooperation programs were completed and the local department of disease prevention and control continued to cooperate with MSM CBOs. However, the degree of support funds from the local department was different among different regions. Where the funds were below the half of program funds, the development of MSM CBOs ceased and work slowed down. Besides, there were still some constraints for the survival and development of MSM CBOs, such as insufficient funds, no legitimate identity, the outflow of talents and the unsustainable development.

CONCLUSIONThe survival and development of MSM CBOs was closely related to the development of international cooperation projects in China. Some departments of disease prevention and control took over the cooperation with MSM CBOs when the international cooperation projects were completed. Given the survival cost of MSM CBOs and the constraints of MSM CBOs development, it needs further investigation on how to ensure the local departments of disease prevention and control to take over the cooperation with MSM CBOs and how to cooperate with MSM CBOs.

Acquired Immunodeficiency Syndrome ; China ; Cities ; Communicable Diseases ; Community Health Services ; Financial Support ; HIV Infections ; Homosexuality, Male ; Humans ; International Cooperation ; Male ; Organizations, Nonprofit

We would like to suggest the guideline of use of materials of sexual education for adolescent in school by examining the status of use of materials and by evaluating the video materials frequently used. Survey was done by enquetes on status of use of materials of sexual education from school nurses in 190 primary, 44 middle and 50 high schools in Seoul, Kyonggi-do and Kangwon-do from August 1999 to February 2000. The frequently used 84 videotapes were evaluated on their contents. As for the status of use, 99.3% of subjected schools possessed the materials for sexual education. Decision of purchase was determined according to the review of contents (92.6%). Information about materials was received by the advertisement in newspapers or broadcasting (46.1%) or recommendation of peer teacher (32.4%). Videotape was most frequently used (64.1%) rather than books or CD. Teachers concerns on the materials were the educational content according to developmental stage of students (41.9%), content provoking interest (33.5%) and concrete guide for teacher (10.6%). As for the evaluation of the contents of videotapes, a subject of education was not described out of 46.6%. Videotape producer were mostly the Government-affiliated institutes or non-profit organizations (86.8%). The year of production was indicated from 41.7%. Running time range of 21-30 minutes was highest (55.9%). The price was marked in only one videotape. Subjects of contents were general sexual education (34.5%), sexual violence or sexual harassment (21.4%), pregnancy and contraception (14.2%) and AIDS and sexually transmitted diseases (8.3%) and dating and adolescent change (4. 8%), and etc (11.9 %). According to above results, we suggested that materials for sexual education should be completed with a description on the subjected group, summary of content, information on the tape producer, year of production, running time and sale price.
Academies and Institutes ; Adolescent* ; Child* ; Commerce ; Contraception ; Education* ; Gangwon-do ; Gyeonggi-do ; Humans ; Korea* ; Newspapers ; Organizations, Nonprofit ; Pregnancy ; Running ; Seoul ; Sex Offenses ; Sexual Harassment ; Sexually Transmitted Diseases ; Videotape Recording ; Periodicals ; Child Health

The objective of this study is to develop a nutrition policy on food and nutrition labeling and education systems for fast food and carbonated soft drinks in Korea by identifying the fast food and soft drink use and by examining nutrition policies and labeling in Korea and other countries. Fast food is defined as food dispensed quickly at a restaurant generally offering a limited menu of inexpensive items, which may be mostly not nutritious. It is a growing component of the Korean diet, especially on children and adolescent population. Low nutrient dense beverages such as carbonated drinks are also increasing in the children and adolescent's diet in Korea and concern has been raised that these beverages may replace more nutritious beverage and provide empty calories. According to 2001 Korean national health and nutrition survey, fast food and carbonated soft drinks were most popular among 13 - 19 years old adolescents. Thirty six and 72 percent of adolescents consumed hamburger and carbonated beverage equal to or more than once a week, respectively. In United States, all processed food including soft drinks should disclose full nutrition information by nutrition labeling requirement. Restaurant foods are not required to provide nutrition information currently, but legislation on mandatory nutrition labeling of fast foods with other restaurant foods has been proposed currently in US. The sales of foods of minimal nutritional value, such as soft drinks, in the nation's schools is regulated by the United States Department of Agriculture. Nutrition information about fast food in US has been provided by fast food companies, non-profit organizations, hospitals and government through internet, booklet and brochure, etc, but the information is available from only a few resources in Korea. This study suggests a nutrition policy on fast food and soft drink use which includes establishing mandatory nutrition labeling and developing nutrition education materials and programs by web-site, booklet and government and school programs in Korea.
Adolescent ; Beverages ; Carbon* ; Carbonated Beverages* ; Child ; Commerce ; Diet ; Education* ; Fast Foods* ; Food Labeling* ; Humans ; Internet ; Korea* ; Nutrition Policy* ; Nutrition Surveys ; Nutritive Value ; Organizations, Nonprofit ; Pamphlets ; Restaurants ; United States ; United States Department of Agriculture ; Young Adult

The Korea Association of Health Promotion and Japanese Organization for International Cooperation in Family Planning (JOICFP), and Taiwan's Chinese Foundation of Health all originated from parasite control organizations. Currently these organizations hold no apparent relations to parasite control activities. However, many of the senior leaderships of these organizations including presidents, have parasitology as their background. Kunii Chojiro (the founder of Japan Association of Parasite Control (JAPC) and JOICFP) explained it as “it all started from worms.” In 1949, Kunii Chojiro established JAPC after personally experienced intestinal parasite infection. The JAPC people conducted mass examination and mass chemotherapy focusing on school children, which allowed them to have sustainable income. In 1965, the Korea Association of Parasite Eradication (KAPE) requested JAPC to assist Korea's parasite control activity. In 1968, when Korea-Japan cooperation for parasite control activity established, Japan's operating procedures were directly absorbed by KAPE. With support from JAPC and official development aid through Overseas Technical Cooperation Agency in Japan (now Japan International Cooperation Agency), Korea successfully controlled parasite infection. Post-war and cold-war geopolitics had a significant impact on Korea-Japan cooperation. In 1960s the president of KAPE, Chong-Chin Lee and Kunii Chojiro were well known figures in population control network. They did understand the importance of population control, but did not agree with the approaches taken by western population control experts. From their point of view, it had to be self-initiated, economically self sustainable grass-root activities rather than top-down activities, as experienced in their parasite control in Japan and Korea. This lead to a new Asian model named “Integrated Program”. Together with their influence in population control network, Kunii and Lee manage to secure the fund from IPPF. Emergence of Integrated Program showed how collective experience of Asia, as well as overlap of networking formed ‘Asian Model’ of public health activities. Kunii and Lee shared the same agenda to enable people to have better life through public health measures. While they funneled money from global population control network, they were more interested in securing sustainability of the parasite control activities. This paper focuses on activities and experiences of Kunii Chojiro and Chong-Chin Lee to show interplay of Cold War geopolitics in Asia led to emergence of Asian network.
Asia ; Asian Continental Ancestry Group* ; Child ; Communicable Disease Control* ; Drug Therapy ; Family Planning Services ; Financial Management ; Health Promotion ; Humans ; International Cooperation ; International Planned Parenthood Federation ; Japan ; Korea ; Leadership ; Parasites* ; Parasitology ; Population Control ; Public Health

Electronic health records (EHR) hold promise in improving the quality and efficiency of health care, yet the health care system remains years behind other industries with respect to the adoption of information technology (IT). Stakeholders in the medical community, including government and tertiary hospitals, have emphasized the urgent need to adopt IT systems. This paper reviews the current research and development efforts related to EHR in Korea, which have been supported by the government since December 2005, on the basis of the following core EHR components: EHR architectures that incorporate an external, implementation-independent view of a complete EHR; EHR functionality for defining tasks that an EHR system should perform; semantic ontology for developing standard vocabularies at the national level; EHR messaging standards for exchanging data; and clinical decision support systems for improving patient safety. Recent international work on EHR systems and the underlying trends are described, and suitable directions for research and development are suggested under relevant subtopics. Advances in the relevant areas will greatly facilitate our ability to achieve interoperability and promote patient safety. However, EHR systems will perform optimally only if we improve our understanding of the political, structural, and technical foundations for EHR, and reach consensus via collaborations between all the stakeholders in the health care system.
Consensus ; Cooperative Behavior ; Decision Support Systems, Clinical ; Delivery of Health Care ; Electronic Health Records* ; Foundations ; Health Level Seven ; Humans ; Korea ; Patient Safety* ; Semantics ; Tertiary Care Centers ; Vocabulary

In recent decades it has been proved that the success or failure of family planning program in developing countries has tremendous impact on the improvement of health, welfare, as well as the general socio-economic development. Therefore it is worth giving a review of family planning in Korea during the last two decades. We are happy to credit the voluntary leaders, particular1y from the public health sector of universities, who played a key pioneering role in the initiation of the organized effort and for the continued leadership in the development of the national program. The organization of 17,000 village level family planning mothers' clubs in 1968 is one of the most outstanding innovative achievements. Despite such long standing problems as very poor morale of the family planning workers, poor national health care network, and stubborn preference for boys, Korea has been fairly successful in achieving the demographic objectives by reducing the total fertility rate from 6.0 in 1960 to 2.7 in 1968, and by increasing the rate of family planning practice from 9% in 1964 to 49% in 1978.
Contraception/methods ; Family Planning/trends* ; Human ; Korea ; Population Control ; Population Density ; Voluntary Health Agencies