Capacity building and technical assistance in higher education

Capacity Building and Technical Assistance in Higher Education
 
Before Korea’s liberation, access to higher education remained largely limited. Imperial University, which would eventually be reorganized into SNU, was established by the Japanese. Enrollment at Imperial University during Japanese rule was very selective and limited to a small percentage of Koreans.30 After Korea’s liberation, a number of national and provincial universities and colleges were established. Most of the increase came from the rapid growth of private, degree-granting colleges. By 1952, the number of higher learning institutions totaled 42 and the number of student enrollment totaled 33,542 (3,958 women).³¹³¹ Despite the expansion of higher learning, Korea’s university system was in need of urgent reform to improve the quality rather than quantity of education. Moreover, Korea suffered a huge deficit in the number of skilled workers and technicians after the departure of the Japanese which held most to the skilled jobs during their occupation. As such, top priority was put on upgrading Korean higher education and research, and secondary and vocational education to support Korea’s economic development.
 
To build up Korea’s technical capacity, considerable amount of financial and technical assistance went into upgrading Korean secondary and vocational education as well as in institutions of higher learning. A good deal of technical assistance was carried out through US technical cooperation programs under “university contracts” which enlisted the participation of US universities and technical institutions to facilitate the exchange of knowledge and skills. The basic objectives of the technical cooperation program were: expansion of education in fields of engineering, medicine, agriculture, and public or business administration; support of specific services or industries, expansion of research, and training of technical manpower. During 1955-59, a total of 1,421 Koreans studied in the US.
 
In Korea, the Minnesota Program provided technical and material assistance to SNU during 1954 to 1961, for the Colleges of Agriculture, Engineering, and Medicine of Seoul National University. Later on, technical cooperation was expanded to include the fields of nursing, veterinary, and public administration. Under the ICA-University of Minnesota (U of M), Korean instructors and administrators studied and observed at the U of M. A total of 226 SNU instructors (77 from the College of Medicine) studies in the US at U of M. Also, a total of 59 US experts and advisors (11 advisors for SNU College of Medicine) were dispatched to SNU to act as in-house consultants, to provide assistance the implementation of new systems and methods adopted by Koreans, under the banner of “assist and not displace.” Material assistance was provided to rehabilitate and improve facilities and to provision new equipment.

One particular program under the Minnesota Program focused on the modernization of Korea’s medical education system, a leftover of Japanese colonial rule, to improve the standards of medical training and healthcare. Under the program, war-damaged medical facilities were repaired; new facilities for training healthcare providers were built including nursing and public health schools; and modern medical equipment, systems and practices were introduced at SNU medical college. But more importantly, this program assisted in the training of professors at the SNU medical college.
 
In 1960, U of M was one of 53 US colleges that participated in the ICA program, which totaled nearly US$ 100 million, with 96 contracts covering 33 countries. To maximize the effectiveness of the program, countries and universities were matched based on various criteria that best suited their conditions. The University benefited from the program which increased the school (Chu, Keun-Won Chu, 80 years of Not Looking Back, 1998, 96p, Lee, Wang-Joon, 2006, p37, recited).
 
[Table 1-1] Technical Cooperation through US Universities
 
 

	US colleges that provided technical assistance
India	Columbia, Berea, Illinois, Kansas State, Missouri State, Tennessee, Wisconsin
Pakistan	Colorado, Indiana, Southern California, Texas A&M, Washington State
Korea	George Peabody, Minnesota, Washington State, Indiana, Syracuse, Oregon
Indonesia	California, Indiana, Kentucky
Japan	Massachusetts, Michigan State
Vietnam	Georgi, Wyoming
Afghanistan	Columbia, Wyoming
China	Michigan State, Purdue
Philippines	New York State
Srilanka	Texas A&M
Thailand	Colorado, Hawaii, Indiana
Cambodia	Georgi
Iran	Brigham Young, Southern California, New York State, Utah State
Turkey	Columbia, Georgetown, Nebraska, Spring Garden Institute
Morocco	Delado Trade-Tech Institute
Tunisia	Delado Trade-Tech Institute
Liberia	Cornell, Prairie View A&M
Nigeria	Indiana, Michigan State, Ohio, Western Michigan
	US colleges that provided technical assistance
Ethiopia	Oklahoma State
Kenya	Earham
Rodesia	Delado Trade-Tech Institute
Uganda	Delado Trade-Tech Institute
Guatemala	Kentucky
Costarika	Lousiana State
Columbia	Tulant
Panama	Tennessee
Ecuador	Mouston
Peru	North Carolina State
Chile	Chicago, Cornell, Pittsburgh, Lelond, Stanford
Paraguay	Bullalo, Montana Michigan State, Purdue, Southern California
Brazil	Johns Hopkins, Michigan, Michigan State, Purdue, Southern California
Austria	New York University

Source: ICA. ICA, Technical Cooperation through American Countries, ICA Office of Public Reports, Washington DC 1956. Recited from Lee (2006, p400)
 

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Source: Kim, Jun-Kyung and Kim, KS. 2012. Impact of foreign aid on Korea's development. Seoul: KDI School of Public Policy and Management. 

 
By end of 1963, the technical assistance activities carried out under US university contracts amounted to more than US $158 with a total of 72 universities performing education and technical assistance under 129 contracts with ICA.32 The number of universities involved and of foreign students enrolled in the programs increased every year since the start of the program. During 1962-1963, nearly 64,000 foreign students were enrolled at US institutions of higher learning. Among the foreign students, 4,619 foreign students were in fields related to medicine and public health. Nearly 40% of the students were self supported, while 24% were supported by US universities, 15% by private organizations, 10% by US aid and 6% by foreign governments. More than 1,000 foreign medical scholars or faculty studied in the US during 1962-1963, many funded by US aid. Based on percentages, 38% of all foreign medical graduates working in the US came from Asia and Far East.33
 
[Table 1-2] Summary of Technical Cooperation Programs under US University Contracts
 
 

	December 1961	March 1964
Number of US University Contracts	186	252
Number of US Universities involved	87	119
Number of Contracts involving overseas activity	101	131
Number of US Universities in overseas projects	58	71
Number of US Universities with training contracts	46	72
Funding of University Contracts (millions)	US $ 121	US $ 177

Source: Dodge (1971)
 
[Table 1-3] Korean Medical, Dental, and Pharmacy Colleges in 1952
 
 

	Location		Enrollment as of Oct. 1952
	Permanent	Korean War	Male	Female
Seoul National University Medical College	Seoul	Busan	444
Seoul National University Dental College	Seoul	Busan	280
Seoul National University Pharmacy College	Seoul	Busan	294
Chunnam University Medical College (ChollaNamdo)	Kwangju	Kwangju	530
Kyungpuk University Medical College (Kyongsang)	Taegu	Taegu	397
Ewha Women’s University	Seoul	Busan		411
Severance Medical College (Later Yonsei University)	Seoul	Seoul	79
Seoul Women’s Medical College	Seoul	Busan Seoul Kwangju Severance		255

Source: Dodge (1971)
 
Source: Kim, Jun-Kyung and Kim, KS. 2012. Impact of foreign aid on Korea's development. Seoul: KDI School of Public Policy and Management.

 
 A key part of the cooperation was making sure that the leadership of the SNU were educated and trained, basically to raise awareness amongst deans, so that they would be in line and supportive of the long term goal of upgrading Korean medical education. This was to make sure that the senior management would become agents of change instead of obstacles to reform and progress. The first dean of the Medical College was sent to U of M to receive an intensive 6-month program to study and observe the medical curriculum and facilities, and to engage in discussions with U of M faculty (Lee, Wang-Joon, 2006, p39). This showed the commitment and focus put on changing the mindset of the top leadership at SNU. This contract effectively gave U of M “substantial portion” of the design and implementation of the technical assistance program on behalf of the US aid agency. Indeed, U of M secured the contract on the condition that the ICA and Korean government would not interfere at all on education related decisions, according to Lee Wang-Joon (2006, p40).
 
Nearly all or 80% of the SNU medical staff had been sent to the US for training in the US for a period of three months to four years so that they could return to Korea to upgrade the medical education system, based on American standards. Basically, two groups of Korean instructors and administrators were sent to US. <Table 3-7> shows the composition of SNU faculties that participated in either short-term consultation or long-term degree program. The first group (short-term consultation program) which largely consisted of senior faculty that held administrative positions at SNU was supposed to be for 6-12 months to study and observe US medical system and practices. The second group (long-term degree program) consisted younger faculty who were expected to continue teaching and take up leadership position in the future after returning from studying in the US. As such, the training period for younger faculty was much more intensive and longer between one and three years. However, many of the younger faculties ended up staying longer for up to four years as seen in <Table 3-8>. As noted before, a key provision in the scope of the technical activities was sending selected junior staffs or faculties at SNU to U of M for long-term degree program. As seen in <Table 3-9>, large number of junior faculties participated in long-term degree programs, many of whom were sent in 1955 and 1959. This is quite remarkable considering the patriarchical culture and seniority based culture in Korea where junior faculty was subordinate to senior faculty. Indeed, the technical program put focus on investing in junior faculty, the future of Korea’s higher education.
 
Since the senior faculty was also trained to recognize the importance of instituting new methods and practices, they were supportive of the junior faculty and did not stand in the way of introducing new teaching methods. According to Lee Ho Wang (2005), who was one of first junior faculty to participate in the degree program, believed that the program was critical in facilitating the rapid adoption of new curriculum and teaching methods. Teaching materials were directly taken from U of M without translation. Almost all of the curriculum and examinations were based on U of M. Also, SNU faculty studying overseas were assured of their position after returning to Korea, and were obligated to return to their position at least for one year. The program was not limited to U of M; in fact some Koreans were able to study in other institutions and countries, if appropriate to their studies.38 The contract also specified that U of M would prepare and submit to FOA semi-annual progress report and final report after the completion of the activities.
 
[Table 1-4]| Composition of Technical Cooperation Programs: 1955-1960
 
 

	1955	1956	1957	1958	1959	1960	Total
Short-term consultation	11	8	5	3	17	7	51 (66%)
Long-term degree program	12	-	-	1	13	-	26 (34%)
Total	23	8	5	4	30	7	77 (100%)

Source: Kim, Jun-Kyung and Kim, KS. 2012. Impact of foreign aid on Korea's development. Seoul: KDI School of Public Policy and Management.

 
Under technical cooperation program, a team of faculty from U of M, and consultants were sent to Korea to assist SNU in improving administration, teaching and curriculum. The US advisors also assisted the SNU faculty and staffs in instituting new organizational and administrative methods, and medical systems and practices. The experts also advised SNU in the selection and uses of books, equipments and supplies in consultation with NU. To coordinate the technical program, a chief advisor which represented the U of M, resided in Korea and was responsible for supervision of the performance of all activities. One of the duties of the chief adviser was to coordinate the procurement of equipment by working with each of the colleges in submitting formal requests that was prepared by the SNU faculty in consultation with overall advisors of each college. Then this proposal was sent to the review committee in U of M before being submitted for final approval by the ICA.
 
Moreover, an overall advisor was provided by U of M for each dean of the various schools including agriculture, engineering, nursing, and medical, if requested by the SNU. The overall advisor’s duty was to help in facilitating the goals of the technical assistance program. The role of the advisors was to assist the SNU faculty in implementing new American style medical system and practices, but also to monitor the performance and progress. The chief advisor was also in charge of preparing and submitting a progress report to FOA every six month. In addition, a final report was submitted upon completion of the program by each of the advisors.
 
According to Gault, who was the overall advisor to the Medical School between August 1959 and August 1961, the role of the US advisors was more than providing advisory on teaching and curriculum but also included as a show of support in providing motivation and encouragement to the SNU faculty and the students (Lee, Wang-Joon, 2006, p101). The US advisors a took hands off approach in assisting SNU but they also participated in weekly meetings, delivered the lectures and advised on clinical practices, offered surgical demonstrations and provided individual consultations to SNU staffs. As such the role of advisor was to “assist and not displace” the SNU staffs. US approach of assisting SNU was different from the Scandinavian approach which built a hospital, and provided all the staffs and medical doctors to operate the hospital.
 
The impact of the technical assistance programs like the Minnesota Program on Korean education and development has been the subject of many studies. Mason et al. (1980) writes: “the most significant, and successful, involvement of American aid in education came with the strengthening of undergraduate faculties and the development of graduate level program in … agriculture, and medicine.” In a comprehensive study of US assistance on Korean education, Dodge (1971) writes: “In higher education as a result of the US efforts, SNU’s Colleges of Agriculture, Medicine, and Engineering were upgraded to the point where the programs there would compare favorably to those of high ranking universities anywhere in the world.” Indeed, the US aid administrators were also in high praise of the programs which were assessed to have significantly supported Korea’s development, judging them to be largely effective and beneficial. For example, nearly 50% of 676 Koreans out of a total of 942 over four years that returned to Korea after receiving training were evaluated as having produced outstanding results while 35% were assessed to be moderate and 15% non-productive.
 
In a study of US assistance on Korean medical education, Wang-Joon Lee (2006) also concluded that the program’s objectives were achieved successfully in upgrading Korean higher education and the field of medicine in general. The program was hugely successful in modernizing Korea’s medical education system in the sense that newly trained professors helped to introduce modern methods and practices of medical education. Korea’s medical education system underwent standardization based on American style system that replacing the Japanese style system. Korea’s theoretical centered medical education was changed to a clinical and experiment-driven system. Indeed, many of graduates at SNU Medical College were able to pass the US Examination of Certification for Foreign Medical Graduates (ECFMG) during the 1960s. The traditional didactic based teaching methods were replaced by clinical, case-based education with more emphasis on practical training such as bed-side practices. New practices in medicine were reformed or established such as anesthesiology, radiology, pathology and so forth. In addition, an internship and resident training system was adopted and medical research capacity was upgraded. Furthermore, a nursing school and public health school were newly established. As the original planners of the program had hoped that SNU could be a beacon of higher learning, modern standards and practices and medical education spread very quickly once the newly trained SNU medical professors returned to Korea. Much of the newly acquired knowledge and methods were disseminated through academic associations, and lecture seminars. Indeed, many of the SNU medical professors went on to hold prominent positions at other medical schools, thus facilitated the spread of knowledge.
 
But the program, Lee (2006) argues, was in some ways a victim of its own success. The program did not have the desired outcomes in the short-term, as the underdeveloped healthcare system in Korea led to a mass overseas exodus of the newly trained medical graduate students from SNU. The Korean healthcare sector did experience a mass exodus of newly trained medical doctors, educated and qualified to international standards, left Korea to find work overseas, largely to the US. Starting from 1956, the share of SNU medical graduates immigrating to the US gradually increased before peaking in 1964, when nearly 60% of the graduating class taught at SNU immigrated to the US.
 
To the extent possible, several factors can be attributed to causing this “brain-drain” of Korean medical practitioners. First, most medical doctors sought to operate private practices and clinics. For instance, many doctors at SNU hospital were more interested in working outside of the hospital and were not full time medical staffs. Moreover, western medicine was still a relatively new method of treatment compared to traditional Asian medicine. As such, hospitals were feared by Koreans as “places to die.” Moreover, Korea had not developed enough economically in that it was still relatively poor countries and thus people could not afford medical costs. Hospitals suffered from a low occupancy rate less than 50% in 1960s. Also, Korea’s social safety net was woefully underdeveloped; in that there were no medical insurance programs or measures to help pay for healthcare costs. Another factor that accelerated this mass immigration was a change in US immigration policy. During the late 1960s and early 1970s, the US implemented an immigration policy aimed at attracting newly trained physicians due to a shortage of qualified physicians caused by the expansion of Vietnam War. However, the US would reverse its immigration policy in the late 1970s, which slowed the outflow of physicians from Korea. Around this time, social protection systems were being introduced with the establishment of national health insurance system, scope and size of which grew over time.

Source: Kim, Jun-Kyung and Kim, KS. 2012. Impact of foreign aid on Korea's development. Seoul: KDI School of Public Policy and Management.

 
 The high rate of migration to the US continued through the early 1970s before falling sharply by the mid-1970s. Indeed, SNU Medical College was not the only institution that experienced high migration of graduating students overseas, as seen in the number students that went to overseas as seen below.39

[Table 1-7] Demography of SNU Medical College Graduates during 1956-75
 
 

		Graduates Overseas		Graduates in Korea	Deceased	Other
		US (%)	Other
1956	122	27 (22)	2	54	36	3
1957	150	30 (20)	2	85	27	6
1958	139	50 (40)	-	67	19	3
1959	149	54 (36)	2	68	23	2
1960	142	54 (38)	4	58	18	8
1961	135	57 (42)	1	58	15	4
1962	123	56 (45)	1	53	11	2
1963	131	74 (56)	-	44	11	2
1964	128	74 (58)	1	41	11	1
1965	113	58 (51)	-	48	7	-
1966	117	51 (51)	-	55	9	2
1967	124	60 (48)	-	52	10	2
1968	100	52 (52)	2	43	3	-
1969	103	47 (45)	-	50	6	-
1970	81	39 (48)	-	40	1	1
1971	107	51 (47)	-	53	1	2

		Graduates Overseas		Graduates in Korea	Deceased	Other
		US (%)	Other
1972	99	37 (37)	-	57	3	2
1973	97	21 (22)	-	71	3	2
1974	97	16 (16)	-	79	1	1
1975	109	15 (14)	-	89	4	1
Total	2,366	923 (Ave: 39)	15	1,166	219	44

Source: Lee (2006, p188)
 
[Table 1-8] Diaspora of Korean Medical Physicians (As of Nov. 15, 1974)
 
 

Country	Number	Medical School	Number
US Canada Japan Malaysia West Germany Jamaica Uganda Other	2,834 72 65 18 17 22 34 73	Seoul National University Yonsei University Catholic University Korea University Ewha University Chonnam University Kyungbuk University Pusan University	786 887 250 481 310 195 382 44
Total	3,135		3,135

Source: Kim, Jun-Kyung and Kim, KS. 2012. Impact of foreign aid on Korea's development. Seoul: KDI School of Public Policy and Management.