의학교육논단 (Korean Medical Education Review)

  • 제26권3호
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  • Pages.174-183
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  • 2024
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  • 2092-5603(pISSN)
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  • 2093-6370(eISSN)
연세대학교 의과대학 (Yonsei university college of medicine)
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거버넌스를 중심으로 살펴본 일본과 싱가포르의 의학교육 정책 비교: 한국에 주는 시사점

A Comparison of Medical Education Policies in Japan and Singapore with a Focus on Governance: Implications for Korea

  • 정성수 (충남대학교 의과대학 내과학교실)
  • Sung-Soo Jung (Department of Internal Medicine, Chungnam National University College of Medicine)
  • 투고 : 2024.08.17
  • 심사 : 2024.10.18
  • 발행 : 2024.10.31
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초록

Among Asian nations, Japan, Singapore, and South Korea exemplify countries with high standards of medical quality. This review explores the differences in medical education policies between Japan and Singapore, particularly concerning governance, and discusses the implications for South Korea's medical education policies. Relevant documents were analyzed by referencing scholarly articles and data from governmental and expert organizations in each country. In Japan, advances in medical education policies include initiatives such as the regional quota system and the core curriculum model, which emphasize stakeholder engagement and transparency. However, challenges persist due to limited stakeholder participation, necessitating a transition toward a more equitable governance paradigm. Singapore's model features robust public-private partnerships with minimal direct governmental intervention, emphasizing innovation and community integration, as seen in the Healthier SG project. These case studies demonstrate effective governance involving significant stakeholder collaboration and strategic financial investments. Conversely, South Korea's medical education policies face challenges from a predominantly government-centric approach, with an absence of cohesive governance structures and inadequate involvement from essential professional stakeholders. This situation has led to policy inconsistencies and a deficit of strategic direction, exacerbated by insufficient financial support for educational infrastructure and program development. The experiences of Japan and Singapore indicate that it would be beneficial for South Korea to adopt integrated governance frameworks that prioritize transparency and collaboration. Furthermore, increasing financial investment in medical education could mitigate existing deficiencies and improve the quality and effectiveness of its healthcare education system.

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참고문헌

  1. Scheele F. The art of medical education. Facts Views Vis Obgyn. 2012;4(4):266-9. https://pmc.ncbi.nlm.nih.gov/articles/PMC3987478/
  2. Casiro O, Regehr G. Enacting pedagogy in curricula: on the vital role of governance in medical education. Acad Med. 2018;93(2):179-84. https://doi.org/10.1097/ACM.0000000000001774
  3. Bevir M. Governance: a very short introduction. Oxford: Oxford University Press; 2012.
  4. Klakegg OJ, Williams T, Magnussen OM, Glasspool H. Governance frameworks for public project development and estimation. Proj Manag J. 2008;39(1_suppl):S27-42. https://doi.org/10.1002/pmj.2005
  5. Espinosa-Gonzalez AB, Delaney BC, Marti J, Darzi A. The impact of governance in primary health care delivery: a systems thinking approach with a European panel. Health Res Policy Syst. 2019;17(1):65. https://doi.org/10.1186/s12961-019-0456-8
  6. Claramita M, Setiawati EP, Kristina TN, Emilia O, van der Vleuten C. Community-based educational design for undergraduate medical education: a grounded theory study. BMC Med Educ. 2019;19(1):258.
  7. Musick DW. Policy analysis in medical education: a structured approach. Med Educ Online. 1998;3(1):4296. https://doi.org/10.3402/meo.v3i.4296
  8. World Health Organization. Everybody's business: strengthening health systems to improve health outcomes: WHO's framework for action. Geneva: World Health Organization; 2007.
  9. World Population Review. Legatum Prosperity Index 2024 [Internet]. Walnut (CA): World Population Review; 2024 [cited 2024 Aug 10]. Available from: https://worldpopulationreview.com/country-rankings/legatum-prosperity-index
  10. Organization for Economic Cooperation and Development. Improving governance with policy evaluation: lessons from country experiences. Paris: OECD Publishing; 2019.
  11. Mikkelsen-Lopez I, Wyss K, de Savigny D. An approach to addressing governance from a health system framework perspective. BMC Int Health Hum Rights. 2011;11:13. https://doi.org/10.1186/1472-698X-11-13
  12. World Bank. Worldwide governance indicators [Internet]. Washington (DC): World Bank; 2023 [cited 2024 Aug 10]. Available from: https://info.worldbank.org/governance/wgi/
  13. Barbazza E, Tello JE. A review of health governance: definitions, dimensions and tools to govern. Health Policy. 2014;116(1):1-11. https://doi.org/10.1016/j.healthpol.2014.01.007
  14. Savedoff WD, Gottret P. Governing mandatory health insurance: learning from experience. Washington (DC): World Bank; 2008.
  15. Lee YG. A comparative and analytical study on the types of national standard governance in 10 major countries. Korean Public Manag Rev. 2017;31(3):145-70. https://doi.org/10.24210/kapm.2017.31.3.007
  16. Onishi H. History of Japanese medical education. Korean J Med Educ. 2018;30(4):283-94. https://doi.org/10.3946/kjme.2018.103
  17. Medical Education Model Core Curriculum Expert Research Committee. The Model Core Curriculum for Medical Education in Japan [Internet]. Tokyo: Ministry of Education, Culture, Sports, Science and Technology; 2022 [cited 2024 Aug 10]. Available from: https://core-curriculum.jp/en
  18. Japan health & medical strategy [Internet]. Washington (DC): International Trade Administration, U.S. Department of Commerce; 2020 [cited 2024 Aug 10]. Available from: https://www.trade.gov/market-intelligence/japan-health-medical-strategy
  19. The regional quota system of Japanese medical schools [Internet]. Tokyo: Ministry of Health, Labor and Welfare; [date unknown] [cited 2024 Aug 10]. Available from: https://www.mhlw.go.jp/content/12201000/000759375.pdf
  20. Research, Innovation and Enterprise (RIE) 2020 [Internet]. Singapore: Ministry of Trade and Industry; 2020 [cited 2024 Aug 10]. Available from: https://www.mti.gov.sg/Resources/publications/Research-Innovation-and-Enterprise-RIE-2020
  21. Health Manpower Development Plan (HMDP) [Internet]. Singapore: Ministry of Health; c2021 [cited 2024 Aug 10]. Available from: https://www.moh.gov.sg/hpp/doctors/programmes/ProgrammeDetails/health-manpower-development-plan-visiting-experts
  22. The White Paper on Healthier SG [Internet]. Singapore: Ministry of Health; 2022 [cited 2023 Mar 31]. Available from: https://www.healthiersg.gov.sg/resources/white-paper/
  23. Foo C, Chia HX, Teo KW, Farwin A, Hashim J, Choon-Huat Koh G, et al. Healthier SG: Singapore's multi-year strategy to transform primary healthcare. Lancet Reg Health West Pac. 2023;37:100861. https://doi.org/10.1016/j.lanwpc.2023.100861
  24. Singapore: a primary health care case study in the context of the COVID-19 pandemic [Internet]. Geneva: World Health Organization; 2023 [cited 2024 Aug 10]. Available from: https://www.who.int/publications/i/item/9789240079793
  25. Shon C, You M. Evaluation of health policy governance in the introduction of the new DRG-based hospital payment system from interviews with policy elites in South Korea. Int J Environ Res Public Health. 2020;17(11):3757. https://doi.org/10.3390/ijerph17113757
  26. The Japan Vision: Health Care 2035: executive summary [Internet]. Tokyo: Ministry of Health, Labor and Welfare; 2015 [cited 2024 Aug 10]. Available from: https://www.mhlw.go.jp/seisakunitsuite/bunya/hokabunya/shakaihoshou/hokeniryou2035/assets/file/healthcare2035_proposal_150703_summary_en.pdf
  27. Ministry of Health and Welfare. 2nd Basic Plan for Public Health Care (2021-2025) [Internet]. Sejong: Ministry of Health and Welfare; 2021 [cited 2024 Aug 10]. Available from: https://www.mohw.go.kr/board.es?mid=a10401000000&bid=0008&act=view&list_no=367810&tag=&nPage=2
  28. Gyeonggi Public Health Policy Institute. Current status and future challenges of long-term planning in healthcare. Issue Brief [Internet]. 2023 [cited 2024 Aug 10];(299):1-20. Available from: https://www.ggpi.or.kr/images/issue/issue29.pdf
  29. Park EC. The urgent need to establish the plan for development of health and medical services. Health Policy Manag. 2019;29(3):245-7. https://doi.org/10.4332/KJHPA.2019.29.3.245
  30. Kim SY, Lee DH. Necessity and direction of Health Care Development Plan. Healthc Policy Forum [Internet]. 2020 [cited 2024 Aug 10];18(4):14-8. Available from: https://rihp.re.kr/doc/18_4/ksy.pdf
  31. Current health expenditure (% of GDP): Singapore [Internet]. Washington (DC): World Bank Group; 2024 [cited 2024 Aug 10]. Available from: https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=SG
  32. Korea Medical Association; Research Institute for Healthcare Policy. A study on the cost estimation and the public support of physician training program [Internet]. Seoul: Korea Medical Association, Research Institute for Healthcare Policy; 2020 [cited 2024 Aug 10]. Available from: https://rihp.re.kr/bbs/board.php?bo_table=research_report&wr_id=297
  33. Jung HN, Yang E. A study on the development of education cost model and estimation of education cost in medical school. J Econ Financ Educ [Internet]. 2020 [cited 2024 Aug 10];29(3):27-56. Available from: https://www.dbpia.co.kr/journal/articleDetail?nodeId=NODE10704967 10704967
  34. Korean Council on Medical Education. Korean medical education status and future strategy report [Internet]. Seoul: Korea Association of Medical Colleges; 2020 [cited 2024 Aug 10]. Available from: https://www.kamc.kr/main/index.php?m_cd=56&page=1&sp=2&b_id=20240320182945575
  35. Clark NM, Gong M, Schork MA, Evans D, Roloff D, Hurwitz M, et al. Impact of education for physicians on patient outcomes. Pediatrics. 1998;101(5):831-6. https://doi.org/10.1542/peds.101.5.831
  36. Eun JH, Yang HM. Exploratory research on an accountability index for collaborative governance focusing on cases of community centers in Korea [Internet]. Seoul: Korea Institute of Public Administration; 2009 [cited 2024 Aug 10]. Available from: https://www.kipa.re.kr/site/eng/research/selectBasicView.do?seqno=26
  37. Lee MS. Collaborative governance and publicness. Mod Soc Public Adm [Internet]. 2010 [cited 2024 Aug 10];20(2):23-53. Available from: https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART001473381
  38. Kang HS. A study on management strategy of government-coordinating governance system: focused on the scope and role of stakeholders and determinants of governance capacity. Korean Soc Public Adm [Internet]. 2003 [cited 2024 Aug 10];14(3):201-27. Available from: https://kiss.kstudy.com/Detail/Ar?key=2264746