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Perspective |
1 Department of Radiology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 62 Yeouido-dong, Youngdungpo-gu, Seoul 150-713, South Korea.
Received March 3, 2008; accepted after revision March 6, 2008.
Address correspondence to J. I. Jung
(jijung{at}catholic.ac.kr).
Keywords: Korea • radiology
Before Western medicine was introduced, medicine in Korea traditionally consisted of "Oriental med icine." Western medicine began to be introduced after the missionary physician, Horace Allen, established in 1885 the Kwang Hye Won, which is the predecessor of the current Severance Hospital. The first significant introduction of radiology in Korea was when the Japanese radiologist, Motoharu Suzuki, visited Korea and provided radiology education in 1921 and 1922. With the end of World War II and Korean independence in 1945, the Korean Radiological Society (KRS) was formed, with an initial membership of 40, including technicians. Although Korea experienced unprecedented tragedy during the Korean War from 1950 to 1953, the country then began to make rapid progress and the KRS also began to achieve remarkable development, culminating in its 2007 membership of 2,703 radiologists.
To become a radiologist in Korea, a medical university graduate must finish a 1-year internship followed by 4 years of residency courses in a radiology department. The candidate must then pass the Korean radiology board examination. In general, university hospitals and large, general hospitals have taken charge of resident education and, in 2007, 517 radiology residents were receiving training in 81 hospitals.
After becoming board-certified, a radiologist who wishes to practice a sub specialty may pursue 1 or more years of subspecialty fellowship training at a hospital that provides such training. Although this decision is totally arbitrary, the number of general radiologists who pursue subspecialty fellowships is gradually increasing.
The KRS publishes two official journals. The Journal of the Korean Radiological Society has been published since 1964 (www.radiology.or.kr/journal/index.php) and is issued monthly. This journal is published in either English or Korean and all articles have an English abstract and title. The other official journal of the KRS is the Korean Journal of Radiology (www.kjronline.org), which has been published since 2000 and is published in English. At the beginning of its publication, it was issued quarterly, but it has been published bimonthly since 2007. It is designated as a Science Citation Index Expanded journal [1]. Both of these journals are equipped with online submission and peer review systems.
The official academy meeting is held annually under the auspices of the KRS; the meeting is held for 3 days in October and there were as many as 1,866 participating attendees in 2007. Regarding the subject presentation, in 2007 there were 345 oral and 309 poster presen tations and 110 lectures. Subspecialty groups under the KRS started as small group meetings held during the 1980s and eventually expanded to include 10 subspecialty societies, including the Korean Society of Neuro radiology and Head and Neck Radiology (www.ksnhnr.org), the Korean Society of Thoracic Radiology (kstr.radiology.or.kr), the Korean Society of Abdominal Radiology (ksar.radiology.or.kr), the Korean Society of Pediatric Radiology (kspr.radiology.or.kr), the Korean Society of Urogenital Radiology (ksur.radiology.or.kr), the Korean Society of Interventional Radiology (intervention.or.kr), the Korean Society of Breast Imaging (ksbi.radiology.or.kr), the Korean Society of Cardiovascular Imaging (kosci.co.kr), the Korean Society of Musculoskeletal Radiology (ksms.co.kr), and the Korean Society of Interventional Neuroradiology (www.ksin.or.kr). Each of these societies holds monthly meetings to discuss interesting cases as well as twice-yearly imaging conferences for residents, and the academic convention and symposium takes place once each year. In particular, the Korean Society of Thoracic Radiology operates a weekly quiz site (kstr.radiology.or.kr/weekly/index2.php) that is open to all radiologists and other physicians both in Korea and internationally. There are currently approximately 30 participating countries, making this one of the world's more frequently accessed thoracic radiology sites.
The Korean health care system is presently administered by the National Health Insurance Program, which is managed by the Korean Ministry of Health and Welfare. This program covers the entire Korean population and is the equivalent of a Korean social security system. Most medical examinations and diagnostic procedures have predetermined fees. These medical fees consist of the patient share and the national share, with the patient share usually less than the national share. Patients can visit primary and secondary hospitals without a referral, but patients must have referrals from primary and secondary hospitals to be treated at tertiary hospitals. However, when patients are referred to tertiary medical institutions, hospital selection is unlimited, and there is practically no delay in scheduling a medical examination when a patient transfers from the primary or secondary health care institution to the tertiary health care institution. Most radiology examinations and procedures are covered by the National Health Insurance Program. Most medical fees and surgical costs are affordable and, in some circumstances, the fees are limited according to the disease category.
Most radiologists, approximately 70%, work at training hospitals such as university hospitals or at general hospitals, and the proportion of private radiology practitioners is low, approximately 13% in 2007. Most Korean radiologists stay and work in the country, while a few emigrate overseas. From 1950 to 1970, emigration opportunities were given to many Korean physicians, and as the number of Korean physicians studying radiology in the United States increased, the Korean Radiological Society of North America (KRSNA) was formed to inspire friendship and collaboration among Korean radiologists and to help transfer advanced medical practices to Korea. However, opportunities for Koreans to receive resident training in the United States decreased after 1970, and as Korean political and economic situations began to significantly improve, the number of emigrating Korean physicians also decreased. Currently, there are few radiology residents or fellows who choose to train in the United States, although many Korean radiologists working at Korean university hospitals still visit overseas radiology institutes, primarily in the United States, for 1 or more years to advance their careers by becoming visiting scholars.
Important current issues of the KRS include internationalization and image quality control. For example, the international subject presentations given by members of the KRS have increased (192 scientific presentations at the 2007 annual meeting of the Radiological Society of North America [RSNA], the fourth largest number among all presenting countries), and Korean publications in the major international academic journals also continue to increase. For example, in the AJR, Korea is ranked as the third country in the number of articles submitted [2]. In addition, there are increased efforts by Korea to host international academic meetings, and the 12th Asian Oceanian Congress of Radiology is scheduled to be held in Seoul October 24–28, 2008. Through these activities, efforts to improve the international awareness of KRS members and to promote international collaboration are continually being made.
In addition, because of the increase in the various types of imaging instruments during the past several years, image quality control has become an important issue in Korea. For that reason, the Korean Institute for Accreditation of Medical Imaging (KIAMI) was established in 2004 under the Ministry of Health and Welfare to assure image quality management for mammography, CT, and MRI. Through these efforts, there have been substantial accomplishments. In addition, practice guidelines and technical standards have been announced by each subspecialty to acquire images that meet established levels of quality.
Finally, the increase in the number of women radiologists corresponds to the continuing social changes in Korean society and to the overall changes in the medical community. The social advancement of women has, in general, progressed rapidly as has also been the trend in the medical community. Although women physicians formerly composed 20% of the general medical population, the current proportion of women undergraduate students in Korean medical colleges is as high as one third. In the case of radiologists, the proportion of women doctors is higher compared with other subspecialties, and since 2005, newly certified women radiologists in Korea outnumbered newly certified male radiologists. Therefore, the future role of women physicians is expected to increase in importance.
Even during a relatively short period of time, radiology in Korea has developed significantly. These developments were pos sible because of the insight and passion of the Korean medical forerunners. On the basis of these developments, the international advancement of the KRS is expected to continue.
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