Since the inter-Korean summit on Friday, healthcare experts are increasingly comparing North Korea’s healthcare system to that of South Korea.

In the North, people must graduate from a six-year medical university to become a physician, just like in the South. However, unlike in the South, graduates from medical school can obtain a medical license without taking a state exam in the North. The North has “quasi-physicians,” but such concept is absent in the South.

According to the Ministry of Unification’s “Analysis and integration plan of North Korean healthcare workers in preparation for a reunification” published in 2014, North Korea’s health workforce is divided in three levels – high-class health workers that include physicians and pharmacists, middle-class health workers such as quasi-physicians, quasi-pharmacists, and dispensing chemists, and low-class healthcare workers, including nurses, prosthetists, and radiologic technologists.

Recent data shows that North Korea is estimated to have 300,000 healthcare workers.

According to “Health at a Glance: Asia/Pacific 2012” by the Organization for Economic Cooperation and Development and the World Health Organization, the reclusive country had 3.3 physicians per 1,000 people in 2003. In 2012, South Korea had 2 physicians per 1,000 people.

The number of North Korean nurses stood at 4.1 per 1,000 people in 2003, similar to 4.7 per 1,000 in South Korea in 2011.

“More than 5,000 healthcare workers are nurtured every year in North Korea. There is at least one educational institution in each province to train middle-class health workers, along with a medical school and pharmacy school. Every year, more than 200 middle-class health workers are produced,” the ministry’s report said.

North Korea’s 12 medical universities and one pharmacy school bring up doctors and pharmacists as high-class health workers. Another 13 medical colleges nurture middle-class workers, including quasi-doctors. Medical colleges have a three- or four-year curriculum.
Both physicians and quasi-physicians can treat patients, but quasi-physicians’ treatments are limited in North Korea. Quasi-physicians can neither perform surgery nor prescribe narcotic and psychotropic drugs. Physicians can prescribe a specific medication for up to 21 days, but quasi-physicians have a six-day limit in prescription.

In the North, a pharmacist who graduated from a university of pharmacy can both formulate and dispense drugs, but those who graduated from a college can only dispense medicines.

Nurses, midwives, and radiographers receive two-year education at vocational health institutions. In principle, nurses cannot do stethoscope, intravenous injection, or suture, but they reportedly perform essential intravenous injections and stitching.

In the South, medical schools are divided into the college of medicine, college of Oriental medicine, and college of dentistry. In the North, however, a medical school itself is a comprehensive university, divided into “clinical medicine department,” “Koryo medicine department,” “oral department,” and “hygiene department.”

According to the “Study on how to recognize North Korean defectors’ qualifications for healthcare experts” released by the Korean Medical Association in 2011, physicians are divided into clinical doctors such as internal medicine specialists, surgeons, and pediatricians, and hygiene physicians such as nutrition and hygiene experts and epidemiologists. Oriental medicine practitioners are categorized as Koryo internal medicine specialists, Koryo surgeons, and Koryo pediatricians.

“Koryo medicine department’s education includes 100 hours of acupuncture, moxibustion, cupping, and dispensing Koryo herbal medicine in the fourth and fifth year. At the end of the sixth year, students carry out clinical practices only,” the KMA’s report said. “In addition to Koryo medicine lectures, professors teach Koryo medicine to physicians in the field for two years to nurture integrated doctors who can also offer Koryo medicine therapies.”

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