디지털융복합연구 (Journal of Digital Convergence)

  • 제17권12호
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  • Pages.427-434
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  • 2019
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  • 2713-6434(pISSN)
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  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
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전공의법 시행에 따른 전공의 수련환경 변화

Changes in the Training Conditions of Residents by Enforcement of Medical Residents Act

  • 오수현 (대한의사협회 의료정책연구소) ;
  • 김진숙 (대한의사협회 의료정책연구소)
  • Oh, Su-Hyun (Research Institute for Healthcare Policy, Korean Medical Association) ;
  • Kim, Jin-Suk (Research Institute for Healthcare Policy, Korean Medical Association)
  • 투고 : 2019.10.31
  • 심사 : 2019.12.20
  • 발행 : 2019.12.28
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초록

전공의법은 2015년 12월 전공의의 권리보호, 환자안전, 우수한 의료 인력을 양성하기 위해 제정되었다. 본 연구는 전공의를 대상으로 2015년(1,793명)과 2017년(1,768명) 두 차례 실시한 설문조사 결과를 비교하여 전공의법 시행에 따른 수련환경 변화를 분석하였다. 분석결과, 전공의들은 주당 평균 80시간을 초과하여 근무하고 있었으며('15=92.4h, '17=87.3h), 36시간의 두 배에 달하는 시간을 연속해서 근무하고 있었다('15=89.4h, '17=70.1h). 이 외출산휴가('15=78.5day, '17=82.2day), 표준근로계약서 작성('15=19.3%, '17=40.8%) 및 계약서 교부('15=12.4%, '17=36.1%)도 규정을 준수하지 않고 있었다. 전공의 수련환경은 환자안전 및 국민 건강과 직결되는 문제로 대체인력에 대한 지원, 공정한 수련환경평가와 평가결과에 따른 인센티브 부여, 전공의 및 지도전문의 인건비, 전문과목별 수련 프로그램 개발 비용 등 국가의 지원이 필요하다.

The Medical Residents Act was enacted in December 2016 to protect the rights of residents, and to ensuring the safety of patients, and nurturing good medical human resources. This study analyzed the changes of training conditions according to the enforcement of The Medical Residents Act by comparing the results of two surveys conducted in 2015(1,793 Residents) and 2017(1,768 Residents). As a result, Residents worked over 80 hours per week on average('15=92.4h, '17=87.3h) and they worked twice as many times as 36 hours('15=89.4h, '17=70.1h). Female residents' leave before and after childbirth('15=78.5day, '17=82.2day), Preparation of Standard training contract('15=19.3%, '17=40.8%), Delivery of training contract('15=12.4%, '17=36.1%) did not comply with the regulations. The training conditions of the residents is directly related to the safety of patients and the public's health. National support is needed for the support of substitute workforces, fair training evaluation conditions and incentives based on the evaluation results, labor costs for residents and supervising medical specialists, and the cost of making training programs.

키워드

참고문헌

  1. Korean Statistical Information Service. (2019). Status of manpower by type of medical institution. (Online). http://kosis.kr/statHtml/statHtml.do?orgId=350&tblId=DT_920015N_222&vw_cd=MT_ZTITLE&list_id=350_920015_001&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=MT_ZTITLE.
  2. S. H. Oh, J. S. Kim & P. S. Lee. (2015). A Survey on Training and Working Conditions of Residents in 2015. J Korean Med Assoc, 58, 1179-1189. DOI: 10.5124/jkma.2015.58.12.1179.
  3. S. Y. Yoo et al. (2017). Relationship of Sleep Quality, Physical Stress, Psychological Stress, and Job Stress among Residents. Korean J Health Promot, 17(1), 9-19. DOI: 10.15384/KJHP.2017.17.1.9.
  4. E. K. Chung, E. R. Han & J. Y. Kim. (2015). Working condition, Health and Perceived patient safety among doctors in training : 2014 Korean interns & residents survey. Health Soc Welf Rev, 35, 584-607. DOI: 10.15709/hswr.2015.35.2.584.
  5. J. H. Kim et al. (2019). Survey on the Environment and Condition of Korean Psychiatric Residents from 2016 to 2017 Years. J Korean Neuropsychiatr Assoc, 58(3), 216-229. DOI: 10.4306/jknpa.2019.58.3.216.
  6. D. S. Chung. (2007). A Survey research on the job satisfaction of residents. Doctoral dissertation. Inje University, Gimhae.
  7. J. H. Kim, J. H. Yoon & S. S. Kim. (2015). Association between Long Working Hours and Depressive Symptoms among Interns and Residents in South Korea-2014 Korea Interns & Residents Survey. Journal of Korean Society of Occupational and Environmental Hygiene, 25(2), 236-243. DOI: 10.15269/JKSOEH.2015.25.2.236.
  8. K. C. Wang. (2011). Reformation of Post-graduate medical education system in Korea. J Korean Med Assoc, 54(4), 352-354. DOI: 10..5124/jkma.2011.54.4.352.
  9. E. K. Kang, H. S. Lihm & E. H. Kong. (2013). Association of Intern and Resident Burnout with Self-reported medical errors. Korean Journal of Family Medicine, 34(1), 6-42. DOI:10.4082/kjfm.2013.34.1.36.
  10. H. J. Ki.m, J. H. kim, K. D. Park, K. G. Choi & H. W. Lee. (2011). A Survey of Sleep deprivation patterns and their effects on cognitive functions of residents and interns in Korea. Sleep Medicine, 12(4), 390-396. DOI: 10.1016/j.sleep.2010.09.010.
  11. M. K. Kim et al. (2017). A survey on training and working conditions of residents in 2017. Seoul: Research institute for Healthcare Policy, Korean Medical Association.
  12. The National Law Information Center. (2019). Medical Service Act. no. 16375 (Online). http://www.law.go.kr/lsSc.do?tabMenuId=tab18&query=%EC%9D%98%EB%A3%8C%EB%B2%95#undefined.
  13. The National Law Information Center. (2019). Regulations on Specialist Training and Qualification. no. 28440[Online]. http://www.law.go.kr/lumLsLinkPop.do?lspttninfSeq=61760&chrClsCd=010202.
  14. The National Law Information Center. (2019). The Annual Curriculum of resident. no. 2019-34 [Online]. http://www.law.go.kr/LSW/admRulInfoP.do?admRulSeq=2100000176462.
  15. The National Law Information Center. (2019). Act on the Improvement of Training conditions and status of Medical residents. no.13600[Online]. http://www.law.go.kr/lsInfoP.do?lsiSeq=177754&efYd=20171223#0000.
  16. S.Y.Kim et al. (2013). Current status of training conditions and suggestions to improve childbirth rate of female residents. Seoul: Research institute for Healthcare Policy, Korean Medical Association.
  17. J. W. Kim, U. M. Chae & J. W. Kim. (2013). Training Environment and Future Prospects in Occupational Environmental Medicine. Journal of the Association of Occupational Environmental Medicine Academic Conference, 5, 121-122.
  18. S. R. Kim, S. S. Kim & J. Y. Kim. (2015). Working condition, Health and Perceived Patient Safety among Doctors in Training: 2014 Korean Interns & Residents Survey. Health and Social Welfare Review, 35(2), 584-607. DOI: 10.15709/hswr.2015.35.2.584.
  19. S. H. Oh, P. S. Lee & M. J. Song. (2015). A survey on training and working conditions of residents in 2015. Seoul: Research institute for Healthcare Policy, Korean Medical Association.
  20. S. S. Kim. (2016). Working conditions of interns/residents and patient safety: Painful training might not be authentic. Korean Med Assoc, 59(2), 82-84. DOI:10.5124/jkma.2016.59.2.82
  21. J. S. Eom. (2018). Changes in Regulation of Internal Medicine Residency Training and Evaluation of Teaching Hospitals. The Korean Journal of Medicine, 93(6), 497-500. DOI:10.3904/kjm.2018.93.6.497
  22. C. Ulmer, D. M Wolman & M. M. E Johns. (2008). Institute of Medicine. Resident duty hours: enhancing sleep, supervision, and safety. Washington, DC: National Academies Press.
  23. R. Jagsi, B. T. Kitch, D. F. Weinstein, E. G. Campbell, M. Hutter & J. S. Weissman. (2005). Residents report on adverse events and their causes. Arch Intern Med, 165, 2607-2613. DOI: 10.1001/archinte.165.22.2607.
  24. C. P. Landrigan et al. (2004). Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med, 351, 1838-1848. DOI: 10.1056/NEJMoa041406.
  25. The Ministry of Health and Welfare. (2019). Implementation of administrative disposal of 94 training hospitals not complying with the major medical Resident Law[Online]. http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=10&CONT_SEQ=347770.