Ministry of Health and Welfare revises the related notification…. Many specialists can supervise one foreign trainee doctor.

There is much attention on the government notification of expanding the opportunity for foreign trainee doctors in Korea to participate in clinical training.

In 2013, the Ministry of Health and Welfare made the notification of ‘the approval of limited medical practice for foreign trainee doctors and dentists in Korea’. It was aimed to expand the opportunity to take part in clinical training. Recently, the ministry revised the notification to increase the chance to participate.

According to the revised notification that has been conducted on 23 December, when a training specialist who educates foreign trainee doctors is absent (attending oversea academic conferences etc.), ‘a cooperative training specialist’ can replace the role and the responsibility.

In other words, foreign trainee doctors that couldn’t take part in clinical training, even in limited medical practice when a training specialist was absent, can do so with a specialist in training cooperation (in the same division with a training specialist). It is designed not to decrease the chances for clinical training.

The revision, rather, enables foreign trainee doctors to increase opportunities in terms of getting various experiences with different specialists.

Then, why does the ministry attempt to increase the chances for foreign trainee doctors in Korea?

This is because the ministry wants to help Korean medical services go abroad.

‘Limited medical practice’ that foreign trainee doctors can do

In 2013, the Ministry of Health and Welfare made the notification of ‘approval of limited medical practice for foreign trainee doctors and dentists in Korea’. In a situation where foreign trainee doctors in Korea have increased, it was a supplementary measure to prevent the training focused on observations and field trips because the processes to attend clinical training were vague.

Limited medical practice means ‘the allowed medical practice for foreign doctors in the medical institutes (where they take training. These are hospital-level medical institutes) under the observation of an advisor professor and patients’ agreement’. The notification doesn’t specify special practices. The ministry approves if medical institutes apply.

If foreign trainee doctors do the limited practices, they have to take a 3-month long orientation and the training medical institute applies for Korea Health Industry Development Institute. After that, the ministry needs to approve it. They can do the limited medical practices for up to one year and extension is possible.

But they have to have clinical training experiences for more than 3 years after getting a doctor’s license.

If they wanted to attend clinical training in the past, ‘a training specialist’ had to be with them. If a training specialist was absent for many reasons such as overseas conferences, etc., they couldn’t take part in clinical training.

Given the situation, the Ministry of Health and Welfare made a cooperative training specialist system. If there is a cooperate professor, foreign trainee doctors can conduct medical practices even though there isn’t a training specialist.

The reason why the MHW ‘takes care of’ foreign trainee doctors

The Ministry of Health and Welfare modifies the related notification because it wants to expand the chance of clinical training for foreign trainee doctors, which results in oversea expansion of domestic medical services. To make domestic medical services go abroad, making a network in a foreign country is important. If we show our high-tech medical technology to foreign trainee doctors by expanding the chances of clinical training and enhance Korean image, we might easily build up the network. A few decades ago, Korean doctors went to foreign countries such as America and Japan and learned advanced medical technology in the countries. And they have maintained the relationship until now. This is the same case.

An official at division of global healthcare of the ministry said “there are many Korean doctors who go to foreign countries”. The most important fact is a network with foreign doctors. If foreign trainee doctors come to Korea, the network will be stronger.” The official added, “This is the same as Korean doctors who went to America for training”. There are many doctors from foreign countries. The revision is aimed at providing systematic training for them.”

There was a request from a medical institute where foreign trainee doctors have been trained. An official from the ministry said “There are civil petitions. A training specialist takes turn to train them at some institutes, but if there isn’t a training specialist, some institutes can’t train foreign trainee doctors even though they want to train.” The official added, “I heard opinions from the medical field for about 5-6 months to revise the notification.

Currently, ‘doctors from Saudi Arabia’ make use of it

But there are a few foreign trainee doctors using the limited medical practice system because they have to go through complicated procedures. More precisely, doctors from Saudi Arabia have made use of the system because the system is actively in place caused by government-level cooperation between Korea and Saudi Arabia.

According to the ministry, a total of 52 Saudi Arabian doctors have done limited medical practices in Korea from 2014 when it was substantially implemented to December 2016. The medical institutes to conduct it include Samsung Medical Center, Seoul National University Hospital, Seoul ST. Mary’s Hospital, Asan Medical Center, and Severance Hospital etc.

The official from the ministry said, “We don’t restrict the limited medical practice to doctors from other countries. To do the practice, doctors have to train for 3 months, but there isn’t such training program to include the 3-month long training at civil institutes. In case of Saudi Arabia, we have already prepared for the training program from the agreement between the two countries. Therefore, doctors from Saudi Arabia can do.”

Expand clinical training for foreign trainee doctors; is it O.K.?

The precondition to expand clinical training for foreign trainee doctors is that domestic patients have to take their treatment in small degree. Therefore, some point out it may not be safe for Korean patients to take treatment from foreign trainee doctors who aren’t proved as qualified doctors. It is true foreign trainee doctors should get patient’s permissions, but permission is one thing and safety is another. Foreign trainee doctors aren’t main doctors to treat patients, but they can play many roles in accordance with judgement from a training specialist. From this perspective, the safety issue can’t be ignored.

An official from a university hospital said, “A training specialist has to decide how many opportunities foreign trainee doctors can have for clinical training after evaluating their ability. If their ability is high, they can play many roles.”

The ministry said it is difficult to limit the range of their participation to treat patients. The official from the ministry said, “It is impossible to specify the range of medical practice for foreign trainee doctors in the notification because the difference of individual ability is too big. It should be judged by a training specialist. Patient agreement doesn’t specify how much foreign trainee doctors can treat patients. But Korean doctors should be the main doctors and foreign trainee doctors take part in as supporters.”

The official added, “If there is a problem related to patient safety, a training specialist will take responsibility. In case of the absence of a training specialist, even though a specialist in training cooperation attends clinical training, a training specialist will be responsible for that.”

Taking care of foreign trainee doctors and patient safety, need to find optimum level

The revision driven by the Ministry of Health and Welfare is to provide positive effect on going abroad of domestic medical service, but keeping patient’s safety is more important. The ministry acknowledges and has been deeply concerned about it. It needs to provide more opportunities for doctors to do limited medical practice from other countries. And also, it has to guarantee patient safety.

An official from the ministry said, “We start discussions the way to allow limited medical practice of doctors from other countries in a training program cooperated with civil medical institutes. If the procedures for the practice are too complicated, it isn’t effective. If they are too easy, it is difficult to get qualified doctors. We have to find a balance.”

The official added, “Going abroad of domestic medical services is important. But patient’s safety should be always in consideration. We have discussed the issue with experts in various fields. There will be progress.”

The plan to expand limited medical practice has just started. If clinical training of foreign trainee doctors is expanded as planned, more patients will get treatment from them. There is much attention on whether the ministry can fine the ways not to harm patient’s safety and on whether it can effectively expand the opportunities of clinical training for foreign trainee doctors.

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