Even before the medical community could recover from the shocking incidence of a drunken patient attacking a doctor in an emergency room in Iksan, North Jeolla Province, physicians had suffered a series of assaults every day recently.

In Jeonju, North Jeolla Province, a drunkard kicked a rescue worker and a nurse at a hospital. In Gumi, North Gyeongsang Province, an intoxicated university student hit an intern physician’s head with a steel tray from behind and incurred a serious injury of the intern working at Gumi Cha Hospital.

The chain of such violent incidents prompted many doctors to feel skeptical about their jobs in Korea. An increasing number of Korean physicians say they want to leave for the U.S. or Japan. The number of members of USMLE KOREA, an online community to share information about United States Medical Licensing Examination (USMLE), spiked to 20,510 as of the end of July from 1,091 in 2005.

Then, what is driving them to leave for the U.S.? Korea Biomedical Review met USMLE KOREA operator Lee Joo-won, a medical practitioner working in the U.S., to learn how much Korean doctors are interested in obtaining USMLE and the difference of doctors’ work environment between Korea and the U.S.

Graduating from Inha University’s College of Medicine in 2004, Lee made up his mind to leave for the U.S. after witnessing the government’s forceful implementation of policy to separate drug prescribing and dispensing in 2000. He obtained the U.S. medical license for internal medicine, and geriatric medicine. Now, he works at Gwinnett Clinic in Georgia.

Question: What made you leave for the U.S. to become a doctor?

Answer: I’ve wanted to be a doctor since childhood. However, my uncle, who was a doctor, didn’t want me to go to a medical school. As I insisted, he suggested going to the U.S. to become a doctor. Since then, I had a vague idea of going to the U.S. to be a doctor.

When I was a medical student in 2000, the government forced to ban doctors from dispensing drugs and allow prescriptions only. Since then, I became wide awake about the reality of the Korean medical community and started to plan out how to go to the U.S.

Q: Korean doctors are increasingly interested in obtaining USMLE. Did the number of visitors to your site increase?

A: Every year, the number of Korean physicians moving to the U.S. to work at a training hospital is inching up. Recently, there was a remarkable rise in the number of people with inquiries about acquiring a U.S. medical license on USMLE KOREA’s bulletin boards.

Also, more Korean physicians are going to the U.S. hospital after passing USMLE. The number of physicians who were successful in moving to the U.S. with the help of USMLE KOREA went up to 21 in 2014 from 10 in 2006. In the first half of this year, 18 physicians left Korea to work at U.S. hospitals through our site. Considering those who did not get support from our website, the actual number of Korean physicians moving to the U.S. will be a lot higher.

Considering the number, there will be about 10 times more doctors who are preparing for USMLE and applying for a job at U.S. hospitals.

Q: Why are so many Korean physicians interested in getting a U.S. medical license?

A: Reasons may vary, but one of them is the unreasonable medical system. Doctors should make sacrifices, patients are unsatisfied, and the government does not take actions to correct the wrong system. People think it’s natural to treat interns and residents like slaves at hospitals.

If the government lacks money to fix such culture, it has to admit it at least and discuss how to improve it step by step. However, without any discussion, the government puts all the blame on physicians. This made the relationship between physicians and patients mutually defensive or hostile. In this situation, any doctor would want to quit and leave for a country where a reasonable work culture is provided.

Q: What are the merits of being a doctor in the U.S.?

A: What I felt like a doctor in the U.S. was that the relationship between patients and physicians was healthier in the U.S. than in Korea. Patients respect doctors. In the U.S., I get to hear “Thank you” from patients with a minor cold if I tell them to get rest at home and take Tylenol.

Based on the fact that unhealthy physician-patient relations can negatively affect the patient’s health, doctors have rights to refuse to treat the patient. For example, if a diabetes patient does not comply with a doctor’s prescription of medication without specific reasons, the doctor can refuse to see the patient after several times of warning.

If a patient is abusive or violent, the doctor can refuse to see the patient. The doctor can report a patient’s severe verbal abuse to the police, and the police may arrest the patient upon request.

Fortunately, such a case is very rare. Most of the American patients have deep trust in their attending doctors and follow their guidance. In return, attending physicians are hugely responsible for patient care, and they do their job sincerely.

American physicians have enough time to see a patient. Typically, a doctor spends about 15 minutes per patient, and 30 minutes for a new patient. If consultation takes a longer time, the doctor can seek extra charge from an insurance company.

Q: Is there any particular difference between American and Korean patients?

A: U.S. people have “respect” for doctors. A water pool in my neighborhood allows public safety workers such as police officers, firefighters, doctors, nurses, and soldiers, to use the facility for free every Wednesday.

One day, I was caught by a police officer for speeding on the highway. After seeing my white coat and a stethoscope on the passenger seat, the officer asked if I was a physician and where I was going. As I replied that I was on my way to see a patient, the officer let me go with a light warning and escorted me to go safety all the way to the exit of the highway.

Q: You received medical training in the U.S. Did you see any difference between Korean training and the American one?

A: American medical training was very rational. Interns and residents do not spend nights at the hospital unless they have night duty. If they work longer than a limited time, seniors urge them to go home. I had to raise a family during my training days, but it was so good to have family time in the evening even though I was receiving medical training.

The U.S. training hospitals have similar training programs, meaning that you can get a certain level of knowledge and clinical experience no matter any hospital you get training from. This is because American medical training programs are under the supervision of the Accreditation Council for Graduate Medical Education (ACGME). When I was taking training courses at a small local hospital, “elective rotation” made me move to Beth-Israel Hospital, one of the Harvard Medical Centers. The two hospitals had no difference in training programs, so I easily adapted to the new hospital.

I liked the American culture where interns and residents are treated as equal peers. When I was in Korea, I was used to doing what I was told to do. In the U.S., a senior year resident scolded me for that. He said, “Why do you do what you’re told to do without any opinion, even though you went to a medical school with a smart brain? You and I are equal, and I want you to tell me what you think.”

U.S. hospitals had a separate workforce for electrocardiography and arterial blood gas test. So I was able to concentrate only on a doctor’s job, which was entirely new to me.

Q: Do you have any comments for those who are thinking about whether to obtain USMLE?

A: I know how demanding the Korean medical work culture is. I want to give kudos for Korean physicians who are making efforts to provide advanced medical care under the poor medical system. If you're going to prepare for USMLE and come to the U.S., I wish the best results for you. I hope USMLE KOREA could be helpful. Our site welcomes everyone preparing to pass the U.S. medical license exam or doctors who are already in the U.S. after graduating from a medical school in Korea. I will keep sharing information to help those who prepare for the test. The site will be a right place for active exchanges of information.