Improving rural health in South Korea

Monday, 2 June 2014

A research team from Seoul National University recently visited the NRHA to hear about Australia's approach to shortages of doctors in rural and remote areas. Led by Professor Jong-koo Lee, a leading policy researcher and advisor in South Korea, the research team also visited the Western Pacific Regional Office of WHO in Manila, the Australian Departments of Health and Education, Health Workforce Australia, and Flinders University and the ANU.

The NRHA is closely involved with the issue of GP distribution both in terms of the range of policies that apply and as national manager, for the Australian Department of Health, of the Rural Australia Medical Undergraduate Scholarship (RAMUS) Scheme.

There is a shortage of doctors in rural areas in the Republic of Korea. Since 1979 its main policy for supplying doctors in rural areas has been to offer doctors medical service in rural areas as an alternative to military service. However the number of candidates for this option is falling because of a greater number who are exempted from military duty. There is thus an urgent need to develop a new policy to ensure the supply of doctors in rural regions.

In 2013 the Korean Ministry of Health and Welfare undertook an international study of ways in which doctors can be encouraged to rural regions, including compulsory service programs linked to a specialised education curriculum or scholarship.

The new approach to be taken in South Korea is likely to include special medical school entrance requirements for students enrolling in a rural workforce pathway and development of a specialised rural health education curriculum for medical schools. Also under consideration is a scholarship program for rural doctors, perhaps including a compulsory return of service arrangement, and establishment of an organisation to co-ordinate governmental and professional education and activities for the rural doctors of the future.

One of the Korean research team's main interests in the Australian context are three of the rural medical scholarships offered here: the Bonded Medical Places scheme, the Medical Rural Bonded Scholarship, and the Rural Australia Medical Undergraduate Scholarship Scheme. Also of interest are Australia’s medical education curriculum, continuing professional development arrangements and financial incentives.

Discussion at the meeting focused on the history and structure of Australia's arrangements for recruiting and retaining doctors in rural and remote areas, and the roles of various agencies in the government and non-government sectors. As manager of the RAMUS Scheme, NRHA staff were able to provide the Korean team with detailed insights into arrangements in the highly successful RAMUS Scheme. Also discussed were the roles of the decentralised agencies working in the area in Australia, including Rural Clinical Schools and University Departments of Rural Health.

The impressive and detailed understanding by the Korean team of the complexities of Australia's health system overall meant that the meeting was able to canvass a number of detailed and nuanced aspects of Australia's approach to these important matters.

The NRHA and the Korean researchers and policy makers will remain in contact for the continued exchange of mutually valuable information and support.