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Current trend of accreditation within medical education
안덕선 한국보건의료인국가시험원 2020 보건의료교육평가 Vol.17 No.-
Currently, accreditation in medical education is a priority for many countries worldwide. The World Federation for Medical Education’s(WFME) launch of its 1st trilogy of standards in 2003 was a seminal event promoting accreditation in basic medical education (BME)globally. In parallel, the WFME also actively spearheaded a project to recognize accrediting agencies within individual countries. Theintroduction of competency-based medical education (CBME), with the 2 key concepts of entrusted professional activity and milestones, has enabled researchers to identify the relationships between patient outcomes and medical education. The recent data-drivenapproach to CBME has been used for ongoing quality improvement of trainees and training programs. The accreditation goal has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Although there are many typesof postgraduate medical education (PGME), it may be possible to accredit resident programs on a global scale by adopting the conceptof CBME. It will also be possible to achieve accreditation alignment for BME and PGME, which center on competency. This approachmay also make it possible to measure accreditation outcomes against patient outcomes. Therefore, evidence of the advantages of costlyand labor-consuming accreditation processes will be available soon, and quality improvement will be the driving force of the accreditation process.
안덕선 대한의사협회 2013 대한의사협회지 Vol.56 No.12
Republic of Korea has experienced rapid economic growth over the last several decades. During this period, some medical schools have been founded with inadequate educational resources. Currently, the Korean medical faculties are frustrated due to the sense of inability to improve the quality of education provided by troubled medical schools. In fact, this phenomenon is a consequence of the reckless establishment of new medical schools. Unfortunately, the Ministry of Education, which claims to reserve the right to grant permission to establish new medical schools, cannot manage this situation either. The Ministry is very reluctant to endorse disciplinary measures based on the standards set by the accreditation agency; instead, it insists on using the court system. In East Asia, there is no history of self-regulation, and very often, the power of the government far exceeds that of professional organizations. This can create tension between an accreditation agency and the government. Even though the Korean Ministry of Education has created a new system recognizing the authority of the accreditation agency, it has not taken into account the specialized aspects of medical education. The government has also stated that only the law can mediate the regulation of low-quality education, so the standards set by the accrediting agency are not legally binding. Despite the good quality-control system that has been put in place for the last 13 years by the Korean Institute of Medical Education and Evaluation the Ministry wants to have authority over any corrective measures. Republic of Korea may have achieved democracy at the macro-level, but this is a time when democracy should be implemented with regard to a specific constituency and an important issue.
안덕선 대한의사협회 2013 대한의사협회지 Vol.56 No.5
The abolishment of the internship training program in Korea has become a hot issue in Korea. The internship has traditionally been a general competency build-up process to becoming a practicing doctor. However, despite its relatively long history, there is still no oversight or guidelines for the educational program itself. It is operated individually department-by-department on a rotation basis with no central supervision or clear goals and objectives. Very often,interns are abused as sources of simple cheap labor, performing not only medical duties but also menial administrative tasks as required by each department, without proper educational activity or training. This significant lack of system and structure is a chronic grievance among those who experience it, yet perhaps due to its short duration, is something that is endured and then forgotten. Medical students, however, have largely opposed the abolition, citing the loss of the opportunity for anthropologic exploration of various clinical departments and the chance to build networks to pursue specialty training in the fields of their choice. The key issue at hand is then whether the current problematic student clerkship training can be improved enough to replace the internship program. To do so would require overcoming the fragmented nature of the clinical education culture, which is still quite clannish in nature and based on family values. Whether these cultural barriers can be broken to develop a clerkship training curriculum sufficient to achieve general competency before specialty training is the determining factor for the fate of the internship program.