가정의학과 전공의 수련과정 중 필요한 기본수기

Abstract

Background : There has been no systematic investigation of the necessary core procedures in primary care in Korea. The purpose of this study is to examine the core procedures necessary in primary care and to have the results reflected in residency programs.

Methods : A mail survey was conducted from May 2, to August 20, 1997 among 478 physicians who qualified as a family physician specialist since 1989. The contents of the questionnaire included 1) sex, age, location and size of the hospital 2) of the 93 procedures that should be taught during residency programs as suggested by the [American Academy of Family Physicians] and the [Korean Academy of Family Physicians] a) procedures taught in residency programs, b) procedures performed by practicing family physicians, and, c) procedures considered as necessary in primary care.

Results : 1) Of the 93 procedures, 78 were taught in residency programs, 35 were performed by practicing family physicians, and 77 were considered necessary in primary care. 2) All of the 35 procedures performed by family physicians were taught in the residency programs. Of the 77 procedures considered necessary in primary care, 71 were taught but the remaining 6 were infrequently taught. 3) 7 procedures were taught but were considered unnecessary ; Procedures taught but not actually performed amount-ed to a total of 43. 4) 42 procedures were considered necessary but not performed. 5) More procedures were performed by male doctors(p<0.05). Surgical procedures were performed more often in regional hospitals than those in Seoul and in the larger cities(p<0.05), and more were performed in private practice(p<0.05).

Conclusion : Although almost all of the procedures considered necessary in primary care were taught in residency programs, many procedures were not being performed in current medical practice. We suggest that it would be more effective to intensively train the core procedures than to provide exposure to a wide array of procedures. As the procedures performed were found to vary in relation to sex, location and size of the attending hospital, it would be desirable for training programs to accommodate individual needs, giving residents access to specific procedures needed for their future.