Perspectives of clinical epidemiology in Korea

The establishment of clinical epidemiology has meant the improvement of the quality and quantity of clinical science because clinical epidemiology has contributed to the process of decision making across the full scope of clinical practice, including diagnosis, treatment, and care, as well as prevention. Epidemiological and statistical methodologies have been used to analyze scientific evidence on clinical problems. The orientation of evidence-based medicine introduced in the mid-1990s is the application of clinical epidemiology to clinical practice for individual patients. The concept of evidence-based medical practice has triggered the expansion of the scope and range of methods of clinical epidemiology. In spite of the global situation, the formal activity in the area of clinical epidemiology in Korean Medical Academic Association is negligible, with few clinical epidemiologists involved. One of several approaches to stimulating the practice of clinical epidemiology in Korea would be to foster clinical epidemiology as a specialization of clinical preventive medicine, which is one of the sub-specialties of preventive medicine in Korea.

Problems and their solutions of the proposed health management service act

To deal with the burden of chronic illnesses, the Korean government has planned to adopt the Health Management Service Act (HMS) to reduce risk factors related to lifestyle, including diet and physical activity with reinforcement of dietitians and physical education instructors and other health professionals. We welcome the strategy to expand human resources for preventing cardio-cerebrovascular events (CVE); however, the delivery system of the HMS has stimulated heated debate. The current legislative bill lacks a comprehensive perspective of clinical preventive medicine. It states that HMS is not a medical service, and therefore the HMS facilities are not medical institutions and can be operated independently from medical professionals. By excluding medical specialists who could integrate information from patients in order to prevent CVEs, the bill is incompatible with the main purpose of HMS and will fail to achieve its goal. To suggest a solution to the debate, a patient-centered, evidence-based approach should be established in order to make an arena where all disciplines related to chronic disease prevention can contribute to the HMS. The participation of medical doctors who are fundamental to healthcare is essential for the successful establishment of an HMS delivery system in Korea.

Education of General Medicine. Postgraduate Education of General Medicin. Community Health and Education of General Practice / 医学教育

Japan is trying to reform the social system because of aged population and changes in constitution of diseases. According to recent amendment of the law of community health, municipal offices got much more competence to manage health care activities. Primary care physicians need to have knowledge and technique for community health care.<BR>The devision of general practice must take the responsibility not only in compensating for the lack of highly specialized medical education and medical care system, but also in producing physician capable for coping with changes of social systems. Especially, trainees in this division should learn clinical preventive medicine, and join some activities of community health and social services in community during their postgraducate clinical training periods.