1.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
2.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
3.Current status and implications of policy developments regarding enrollment quotas in Japanese medical schools
Joohyun KANG ; Kye Hyun KIM ; Yohan SHIN
Journal of the Korean Medical Association 2024;67(11):710-716
Following the government’s unilateral announcement to increase medical school quotas, serious concerns are rising over the development of medical education and future healthcare in South Korea. Medical experts are disappointed by the lack of transparent decision-making. Unlike major developed countries that establish specialized bodies with expert involvement to set physician workforce policies, the Korean government plans to create a “human resource supply and demand estimation adjustment system” without sufficient consultation with medical professionals. This study analyzes Japan’s policy process regarding medical school quotas to derive implications for establishing governance for physician workforce supply and demand in Korea.Current Concepts: In Japan, the Physician Supply and Demand Subcommittee, mostly comprising medical experts, conducts in-depth discussions on adjusting physician supply and addressing regional disparities. Their discussions are transparent and publicly disclosed, influencing policy decisions such as gradual adjustments to quotas and measures to improve physician distribution.Discussion and Conclusion: Japan’s approach demonstrates the importance of involving medical experts in policymaking and ensuring transparency. The Japanese government collaborates with medical professionals to accurately project physician supply and demand, and adjusts medical school quotas gradually. In contrast, Korea’s abrupt plan to increase quotas without thorough expert consultation may lead to unintended consequences. It is imperative for the Korean government to form consultative bodies centered around medical experts to engage in in-depth discussions, ensuring that policies are realistic and effectively addressing challenges such as population decline and regional healthcare disparities.
4.The Latest Trends in Attention Mechanisms and Their Application in Medical Imaging
Hyungseob SHIN ; Jeongryong LEE ; Taejoon EO ; Yohan JUN ; Sewon KIM ; Dosik HWANG
Journal of the Korean Radiological Society 2020;81(6):1305-1333
Deep learning has recently achieved remarkable results in the field of medical imaging. However, as a deep learning network becomes deeper to improve its performance, it becomes more difficult to interpret the processes within. This can especially be a critical problem in medical fields where diagnostic decisions are directly related to a patient's survival. In order to solve this, explainable artificial intelligence techniques are being widely studied, and an attention mechanism was developed as part of this approach. In this paper, attention techniques are divided into two types: post hoc attention, which aims to analyze a network that has already been trained, and trainable attention, which further improves network performance. Detailed comparisons of each method, examples of applications in medical imaging, and future perspectives will be covered.
5.The current status and implications of the medical insurance fee schedule in Japan
Yohan SHIN ; Kye Hyun KIM ; Sung Je MOON ; Joohyun KANG
Journal of the Korean Medical Association 2023;66(12):741-746
Korea has the most rapidly aging population in the world. Medical costs for the elderly are quickly increasing, which raises concerns about the sustainability of health insurance finances. Accordingly, the need to allocate limited medical resources efficiently has increased, with improving the fee schedule seen as an effective way to achieve this. Japan has experienced a super-aging society for at least 20 years prior to Korea and has been successful in improving its fee schedule. Korea’s fee schedule, however, needs to overcome the challenge of being relatively limited in type and simplicity.Current Concepts: The new patient consultation fee in Japan is the same regardless of the type of medical institution and is approximately 40% higher than found in Korea. In the case of established patient consultations, the fee for medical institutions with fewer than 200 beds are substantially higher than for large medical institutions, thereby suppressing re-examination at large hospitals. Japan’s additional points consist of 71 types of items, which is more diverse than Korea’s 28 types, and the additional points for children under six years of age, holidays, and late nights are set significantly higher than that found in Korea.Discussion and Conclusion: Japan designed its fee schedule to structurally reduce the consumption of medical resources and to effectively compensate for the behavior of medical providers. This policy is a standard which Korea’s fee schedule should aim for. In the future, it will be necessary to prepare measures to respond to the super-aging environment through detailed research concerning Japan’s fee schedule.
6.The Latest Trends in Attention Mechanisms and Their Application in Medical Imaging
Hyungseob SHIN ; Jeongryong LEE ; Taejoon EO ; Yohan JUN ; Sewon KIM ; Dosik HWANG
Journal of the Korean Radiological Society 2020;81(6):1305-1333
Deep learning has recently achieved remarkable results in the field of medical imaging. However, as a deep learning network becomes deeper to improve its performance, it becomes more difficult to interpret the processes within. This can especially be a critical problem in medical fields where diagnostic decisions are directly related to a patient's survival. In order to solve this, explainable artificial intelligence techniques are being widely studied, and an attention mechanism was developed as part of this approach. In this paper, attention techniques are divided into two types: post hoc attention, which aims to analyze a network that has already been trained, and trainable attention, which further improves network performance. Detailed comparisons of each method, examples of applications in medical imaging, and future perspectives will be covered.
7.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
8.Improvement strategies for accessibility and quality of rehabilitation medicine through a Korea-Japan comparative study
Yohan SHIN ; Kye Hyun KIM ; Bongsik WOO ; Joohyun KANG
Journal of the Korean Medical Association 2024;67(12):781-787
Rehabilitation medicine in Korea has improved significantly; however, the rehabilitation medical delivery system still lacks well-established continuity and comprehensiveness. Since 2000, Japan has implemented a convalescent rehabilitation ward system, with continuous improvements in policies and criteria based on clinical needs. This study compared the rehabilitation systems of Korea and Japan, focusing on institutional standards and the scope of target patients in order to explore directions for enhancing the Korean system.Current Concepts: Japan applies a multi-tiered reporting system for rehabilitation wards, categorizing wards and adjusting reimbursements based on performance indicators such as functional improvement rates, discharge-tohome rates, and rehabilitation effectiveness indices. Additionally, Japan’s policies encompass a broad range of target diseases and flexible admission criteria, improving accessibility. In Korea, the scope of target diseases is relatively narrow, limiting opportunities for patients to receive appropriate rehabilitation treatment.Discussion and Conclusion: Korea could benefit from adopting a multitiered system and performance-based reimbursement structure, as seen in Japan’s model. Expanding the range of eligible conditions and reviewing certification requirements can enhance the accessibility and quality of rehabilitation services. These changes are expected to foster an environment in which patients can receive timely and comprehensive rehabilitation care, thereby facilitating physical recovery and reintegration into society.
9.Liver organoids: Current advances and future applications for hepatology
Yohan KIM ; Minseok KANG ; Michael Girma MAMO ; Michael ADISASMITA ; Meritxell HUCH ; Dongho CHOI
Clinical and Molecular Hepatology 2025;31(Suppl):S327-S348
The creation of self-organizing liver organoids represents a significant, although modest, step toward addressing the ongoing organ shortage crisis in allogeneic liver transplantation. However, researchers have recognized that achieving a fully functional whole liver remains a distant goal, and the original ambition of organoid-based liver generation has been temporarily put on hold. Instead, liver organoids have revolutionized the field of hepatology, extending their influence into various domains of precision and molecular medicine. These 3D cultures, capable of replicating key features of human liver function and pathology, have opened new avenues for human-relevant disease modeling, CRISPR gene editing, and high-throughput drug screening that animal models cannot accomplish. Moreover, advancements in creating more complex systems have led to the development of multicellular assembloids, dynamic organoid-on-chip systems, and 3D bioprinting technologies. These innovations enable detailed modeling of liver microenvironments and complex tissue interactions. Progress in regenerative medicine and transplantation applications continues to evolve and strives to overcome the obstacles of biocompatibility and tumorigenecity. In this review, we examine the current state of liver organoid research by offering insights into where the field currently stands, and the pivotal developments that are shaping its future.