외과의 세분화

다국어 초록 (Multilingual Abstract)

Although the subspecialization of surgical practice and fellowship training have progressed well in most of the university hospitals in Korea, no apparent supervision system has yet been activated. There have recently been active debates and discussions between society members on the issue of a certification for fellowship training, which ultimately prompted the Korean Surgical Society to prepare appropriate measures. In order to facilitate the process of establishing ideal measures, in our unique circumstance of surgical practice, I can suggest some of my personal opinions. First of all, I recommend that the Korean Surgical Society and its all member to strive against government interference and achieve an attending system for surgical practice and to obtain reasonable insurance reimbursement for surgeons’ work, which are all prerequisites for both general and subspecialty surgical practices. Rigorous criteria for approval and credentialing of a fellowship training program should be established, whether certification will be given or not. Certification should be offered only when there is agreement between all the members of subspecialty boards and the association of practicing surgeons. All measures should be taken so as not to compromise surgical residency training by subspecialty fellowship. As subspecialization progresses, the specialty of general surgery also needs to be redefined. A discreet long-range plan of the surgical work force should be done to keep the proper number of both generalist- general surgeons and subspecialist-general surgeons. In order to take the initiative for the moderation of the interests between different subspecialty boards, and to establish a structured fellowship training program, the Korean Surgical Society should reinforce its administrative functions.

목차 (Table of Contents)

• 대한외과학회의 창립과 첫 세분화
• 외과의 세부전문 분과학회의 발생
• 외과의 세부전문화의 필연성
• 외과 세분화의 문제점
• 외과 세분화에 따른 외과의 전문성 개편
• 세부전문의 자격증 수여의 뜻과 영향
• 세부전문의제도 도입과 한국 특유의 문제점
• 외과학회의 대책
• REFERENCES

참고문헌 (Reference)

1 Organ CH, "We are the gatekeeper" 138 : 470-474, 2003

2 Division of Statistical analysis of National Health Insurance Corporation, "Total counts of major surgeries by types of service provider in EDI DB 2004" 2006

3 5)Korean Surgical Society, "Surgical Resident Survey" 2006

4 Korean Academy of Medical Science, "Regulation for certification of subspecialty board"

5 Stitzenberg KB, "Progressive specialization within general surgery: adding to the complexity of workforce planning" 201 : 925-932, 2005

6 Santry HP, "New trends in general surgical training" 91 : 19-24, 2006

7 Langsley DG, "Medical specialty credentialing in the United States" 257 : 22-28, 1990

8 Accredited Council for Medical Graduate Education, "Letter from Residency Review Committee (RRC) to Surgical Residency program directors"

9 Amor KD., "Impact of fellowships on surgical training" 91 : 25-28, 2006

10 Fernandez-Cruz L., "General Surgery as education, not specialization" 240 : 932-938, 2004

11 "Editorial"

12 American Board of Surgery, "Definition of Surgery. American Board of Surgery Booklet of Information" American Board of Surgery 1982

13 Rhodes RS., "Defining general surgery and the core curriculum" 84 : 1605-1619, 2004

14 Ritchi Jr WP, "Basic certification in surgery by the American Board of Surgery. What dose it mean? Doses it have value? Is it relevant? A personal opinion" 239 : 133-139, 2004

15 American Board of Medical Specialty, "Annual Report and Reference Handbook" Evanston 1988

16 Bell Jr RH., "Alternative training models for surgical residency" 84 : 1699-1711, 2004

17 Division of advocacy and health policy, "A growing crisis in patient access to emergency surgical care" 92 : 6-19, 2006

18 Korean Surgical Society, "50 years history of Korean Surgical Society" Medical Cultural Ltd 1997