The 'Korean' Resolution of the Doctorless Village Crisis and the Entanglement with the Conscription System in South Korea in the 1950s-70s.

This article reviews how the crisis of doctorless villages in South Korea in the 1950s-70s was closely linked to the conscription system. In the second half of the twentieth century, South Korea's public health system faced a dual challenge: the colonial legacy of medical shortage and urban concentration, and the massive conscription of military doctors after the Korean War. The term 'doctorless village' was a signifier that reflected these historical contexts, symbolizing the chronic medical crisis in rural areas. Behind the crisis, there as a growing idea of reversing the constraints from conscription and using it as a solution for the doctorless village problem. Initially, the Ministry of Health and Social Affairs planned two alternatives to fill the gaps in the public health network. One was to station military doctors in doctorless villages, and the other was to dispatch civilian doctors in doctorless villages and exempt them from military service. After a series of doctor mobilizations since the May 16 coup, the medical community generally agreed with this plan and publicized it. They developed arguments for alternative services through public health work and strengthened its logic. By the 1970s, the plan culminated in the establishment of the current Public Health Doctor system. In terms of condition and momentum, the introduction of alternative service in other sectors, as well as the extension of the consensus among the government and medical community, accelerated this trend. As a result, the doctorless village crisis in South Korea, which had been a critical issue for a quarter of a century, entered a phase of resolution by utilizing the conscription system as its institutional foundation. It represented an aspect of the 'Korean' public health system characterized by the entanglement with conscription. However, another aspect to consider is that it has imposed additional limitation on medical care in rural areas by institutionalizing the public health system relying on mobilization and minimum budget.

A 10-Year Journey of the USM Master and Doctoral Degrees in Public Health

@#The article introduces readers to the Master of Public Health and Doctor of Public Health programmes, offered by the Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia. The programme vision, structure and accomplishments over the decade are presented to provide an understanding of the programme. It is hoped that this professional programme will continue to flourish and produce new generations of public health medicine specialist equipped with the necessary knowledge and skills to make significant contribution towards improving the health of the population.

Appropriateness of task of public health doctors in South Korea.

INTRODUCTION: Public health doctors (PHDs) in South Korea serve the medically underserved region of South Korea as part of national service duty, but their number has declined in recent years (due to changes in the medical education system). Therefore, there is an increasing need to deploy PHDs efficiently. Consisting of 2138 medical doctors of different specialties, they serve as both primary care physicians and public health experts. METHODS: The purpose of this study was to investigate the appropriateness of tasks of PHDs in South Korea. RESULTS: Of the 2138 PHDs invited, 1015 participated in the survey. Most PHDs performed primary care and vaccination duties (96.8% and 85.8%). PHDs evaluated the appropriateness of tasks and number of PHDs as above the midpoint of a five-point Likert scale (3.5±1.1 and 3.4±1.1). The majority of offices were located within 5 km of private clinics and hospitals (72.7% and 45.2%). CONCLUSIONS: PHDs on remote islands highly value the validity and deployment needs of PHDs, while PHDs in close proximity to private clinics or hospitals give a low score. This suggests that there is a need to more efficiently deploy PHDs depending on local characteristics and the presence or absence of nearby private medical clinics and hospitals.

The cultivation and access of public health specialist in United Kingdom and its inspiration to China / 中华医学教育探索杂志

At present,all parts of our country and the units are on their own to explore the ways and methods of public health physician training,and to develop a unified national public health standardized training system is particularly important.This study introduces the composition and practice of British public health specialist training and its access system,draws on the successful experience of this system and puts forward some suggestions such as paying attention to the cultivation of clinical basic knowledge,rationally using industry associations and societies and so on from the public health doctor training system,which provides the basis for promoting the establishment of a national public health physician training system.

Epidemic intelligence service officers and field epidemiology training program in Korea.

Korea has adopted Epidemic Intelligence Service (EIS) officers through the Field Epidemiology Training Program (FETP) since 1999 for systematic control of emerging and re-emerging infectious diseases. Graduates of medical schools in Korea are selected and serve as public health doctors (PHDs) for their mandatory military service. The duration of service is 3 years and PHDs comprise general practitioners and specialists. Some PHDs are selected as EIS officers with 3 weeks basic FETP training and work for central and provincial public health authorities to conduct epidemiological investigations. The total number of EIS officers is 31 as of 2012. The Korea Centers for Disease Control and Prevention (KCDC) has 12 specialists, whereas specialists and each province has one or two EIS officers to administer local epidemiological investigations in 253 public health centers. The Korean EIS officers have successfully responded and prevented infectious diseases, but there is a unique limitation: the number of PHDs in Korea is decreasing and PHDs are not allowed to stay outside Korea, which makes it difficult to cope with overseas infectious diseases. Furthermore, after 3 years service, they quit and their experiences are not accumulated. KCDC has hired full-time EIS officers since 2012 to overcome this limitation.

Criminal liability of medical professionals

The Medical Service Act and many other laws regulate the actions of medical professionals. Receiving rebates from pharmaceutical companies has been criticized as unethical but not punished until 2011. However, it is now strongly forbidden. Unlicensed acts of medical care, which include providing medical care beyond the scope of the license or giving directions to an unlicensed person to practice medical care, are strictly punished even in the case of licensed medical professionals. It recently became an issue whether a doctor who wrote prescriptions to patients after examining them over the telephone violated the Medical Service Act. In addition, it is necessary to pay special attention to the administration of propofol since it recently became a major controversy. Furthermore, public health doctors are legally forbidden to work outside of a public health institution. The number of regulations on the medical industry is increasing every day. New laws usually toughen up punishment for those violating regulations. There is a legal maxim that says, "Ignorance of law excuses no one." Therefore, it is necessary for medical professionals to steadily study and become familiar with applicable laws and related criminal cases to prevent themselves from becoming criminally liable.

A study on the current state of public health doctors

As the healthcare environment has changed both socially and politically importance of public health doctors' roles has increased and ongoing revision of their roles is also needed in Korea. However, many problems have decreased the job satisfaction of public health doctors. This study aims to determine the factors that influence public health doctors' satisfaction. The survey was conducted over the course of 2 months by questionnaire methodology. A total of 881 respondents (response rate, 90.1%) participated and 778 valid responses were analyzed using SAS version 9.1. Items about arranged organization, work task, employee welfare and services, education, public health doctor's system, and the role of public health doctors were included in the questionnaire. It was found that the satisfaction of many respondents was not high and they had negative perceptions of arranged organization, work, environment, employee welfare and services, education, system, and their own role. Although the public health doctors have professional knowledge of healthcare, they were not satisfied with their role because they were required to do inappropriate work, improperly arranged and found performing work difficult when treated unfairly or not paid fairly. Therefore, policies focused on financial compensation or system improvement must be established to increase the satisfaction of public health doctors. This study's limitation was that the survey was done through two modalities. However, it is meaningful that issues related to the public health doctors were dealt with more comprehen-sively in this study than other studies.

Shortage of public healthcare personnel, is it a problem of number of doctors?

In 2012, the Korean government and various civic groups are insisting to increase in the number of Korean medical graduates by 20% to 100% because of the shortage of public healthcare doctors. However, we have to think of the real point of what makes the pulic heathcare system. In fact, Korea is the country with the least public spending on health care within the Organization for Economic Cooperation and Development. Moreover, the problem with Korean public healthcare are many and profound; regional disparity of medical personnel including doctors and nurses, out-rageously low spending on the public healthcare sector, wrong allocation of public health doctors in lieu of compulsory military service, and no coordination between the public and private health care sector, which thus indicate a very complicated problem with numerous variables. The proper way to solve this problem would be to understand these variables and act accordingly.

The Experience and Competence of Physicians Who Provide Emergency Health Care at Public Health Sub-Centers on Remote Islands in Korea / 農村醫學 地域保健

OBJECTIVES: To investigate the experience and competence of physicians providing emergency medical services at public health sub-centers on remote Korean islands. METHODS: This study enrolled 79 doctors who work at public health sub-centers on remote Korean islands. Data were collected in December 2009 via self-administered e-mail questionnaires. The response rate was 44.3%. RESULTS: Emergent situations occurred at most (58.68%) of the public health sub-centers that were surveyed in December 2009. An average of 1.92 cases required treatment by public health physicians. Only 20.25% of the physicians were specialists in emergency medicine, while the remainder were general practitioners (GPs) without clinical experience as emergency doctors. We also found that the physicians we surveyed had insufficient knowledge of emergency medical care. At some health centers only one doctor was available, and there was no medical team in holiday, although most of the physicians indicated that the ideal number of doctors per center was two or three. In cases of emergency, patients were often sent to the mainland by ship without receiving first-aid treatment. The public health sub-centers lacked the necessary medical equipment to save lives in emergencies and lacked escort systems for emergency patients. CONCLUSIONS: The Korean government should address the importance of providing emergency care in remote areas. Health administrators should provide suitable manpower, medical equipment, guidelines for emergency medicine, and education for public health physicians on remote islands.