Sub-Theme 4 | Lessons Learned
Korea is now in the position to act as an important development partner for developing countries, leveraging its experiences as a recipient country. ##MORE_LAYER_BOX##The Korea International Cooperation Agency (KOICA), the Korea Foundation for International Healthcare (KOFIH), and many other NGOs are currently running fellowship invitation programs and local training programs in developing countries as part of Korean assistance efforts.##MORE_LAYER_BOX_END##
Korea learned many lessons throughout its development experiences in health professional education in the latter half of the 20th century, with the most significant explained below.
Interactive Relationship Between Economic and Healthcare Development
We reviewed three projects that greatly contributed to innovating healthcare and medicine in Korea and to developing the capacity of Korean health professionals. However, without the rapid economic growth which is often referred to as "The miracle of the Han River," sustained development would have been impossible. ##MORE_LAYER_BOX##In particular, such economic development enabled expansion of the healthcare market, spurred higher expectations among the Korean people for better healthcare which in turn inspired a drive for innovation in the field, and attracted talented people to the healthcare field due to the relatively high income of doctors.##MORE_LAYER_BOX_END##
And healthcare development itself also had a positive influence on economic development by improving population health, reducing disease burden, and promoting the rehabilitation of the people.
Selection and Concentration
Despite many objections, the Minnesota Project selected and focused on a single institution, SNU. This is of particular importance in terms of the impact of the project, because if the ICA had dispersed its limited funds across several institutions, the results would have been far smaller.
In 1961, 70 percent of the professors at SNUMC had studied abroad through the program—a high enough percentage to form a critical mass for institutional change. If only 20 or 30 percent had studied abroad, fewer changes and innovations would have been made in the Korean medical environment, especially given the country's conservative, hierarchical system.
Concentration was also applied to the selection of fellows for the program. Among 77 fellows, 33 were teaching assistants without salaries who were awaiting paid positions. These assistants were allowed to stay in the United States for two or three years, and some earned an academic degree in their specialty. These young professionals, full of patriotism and ambition after a long period of hardship caused by colonialism and the Korean War, saw an opportunity to make a huge difference in their country.
Diffusion of Innovation
The principle of selection and concentration was closely linked to the plan for diffusion of innovation. From the beginning years of the Minnesota Project, through to the CMB project and onwards to the NTTC initiative, professors at the SNUMC functioned as evangelists of new American medicine.
As members of a privileged institution, SNUMC professors were often invited to other medical colleges to give special lectures. They also influenced the curriculum of other medical colleges, led almost all academic societies, published articles on what they had experienced in the United States, and translated English-language American textbooks into the Korean language. Furthermore, the SNUMC spread what they learned through the NTTC, which was officially recognized as a center for faculty development by the Korean government.
Focus on HRH(Human Resources for Health) Development
The most significant characteristic of the three projects was the program design, which focused on the development of human resources. Many different forms of assistance for developing countries had come into existence from the end of World War II. But assistance focused on material supply, such as buildings, equipment, tools, and medication carried a high probability of failure. ##MORE_LAYER_BOX##Even today, it is very common to see high-technology machines that have been provided to developing countries being wasted because these countries lack the human resources required to make use of them. Assistance focused on implantation of institutions also has a high chance of failure. It is not uncommon to see the improper or distorted running of implanted institutions because the human resources in charge of them lack the understanding and/or the motivation needed to operate the institutions effectively.##MORE_LAYER_BOX_END##
Projects for the SNUMC, however, were different. They focused first on developing the capacity for human resources and then on supporting them with the facilities and equipment they would need to reach their full potential. Regarding institutional change, the projects did not build new systems or institutions directly, but facilitated the decision-making of members of the recipient organization so that new systems could be established that were compatible with their own academic, political, and cultural environment.
Advisory services also emphasized sustainable HRH development. Advisors were not there to replace Korean professors; rather, they were there to pass on their knowledge and skills to Korean professors to enable the latter to do the job on their own.
Continuity and Harmonization Among Different Aid Programs
As we reviewed in this paper, the SNUMC received technical assistance from the Minnesota Project (1954 to 1961), the CMB Project (1963 to1986), and the NTTC Project (1975 to ongoing). Each project was supported by different organizations, but in a well-coordinated continuum. ##MORE_LAYER_BOX##The Minnesota Project rehabilitated the SNUMC and transformed its approach from Japanese medicine to the American model; the CMB took over the former project with more emphasis on self-development of the SNUMC; and finally the NTTC functioned as a channel for diffusion of all the innovations the SNUMC had achieved. We can observe many development assistance projects stopped prematurely, ending in vain. Korea’s case is a good example of the opposite: assistance projects that resulted in sustainable development.##MORE_LAYER_BOX_END##
Proactive Role of Beneficiary Institution
In the international cooperation field, we can observe many beneficiary institutions that passively wait for the favors of donor institutions. Two years after the end of the Minnesota Project, the dean of the SNUMC contacted the CMB to request a consultant, and the CMB answered that requesting by sending Dr. Gault, who had served as the advisor of the Minnesota Project. This became the momentum to increase the size of CMB support. What we can take away from this example is the absolute importance of the beneficiary institution taking a proactive attitude toward assistance programs.
|Subject||Social Development < Health|