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J Educ Eval Health Prof > Epub ahead of print
J Educ Eval Health Prof. 2021; 18: 7.
Published online April 20, 2021.
[Epub ahead of print]
Changes in the working conditions and learning environment of medical residents after the enactment of the Medical Resident Act in Korea in 2015: a national 4-year longitudinal study
Sangho Sohn1  , Yeonjoo Seo2  , Yunsik Jeong3  , Seungwoo Lee4  , Jeesun Lee5  , Kyung Ju Lee6,7 
1Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
3Damyang-gun Public Health Care Center, Damyang, Korea
4Department of Psychiatry, Dankook University College of Medicine, Cheonan, Korea
5Korean Intern Resident Association, Seoul, Korea
6Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
7Institute for Occupational and Environmental Health, Korea University, Seoul, Korea
Correspondence  Kyung Ju Lee ,Email:
Editor:  Sun Huh, Hallym University, Korea
Submitted: February 6, 2021  Accepted after revision: April 6, 2021
In 2015, the South Korean government legislated the Act for the Improvement of Training Conditions and Status of Medical Residents (Medical Resident Act). This study investigated changes in the working and learning environment pre- and post-implementation of the Medical Resident Act in 2017, as well as changes in training conditions by year post-implementation.
An annual cross-sectional voluntary survey was conducted by the Korean Intern Resident Association (KIRA) between 2016 and 2019. The learning and working environment, including extended shift length, rest time, learning goals, and job satisfaction, were compared by institution type, training year, and specialty.
Of the 55,727 enrollees in the KIRA, 15,029 trainees took the survey, and the number of survey participants increased year by year (from 2,984 in 2016 to 4,700 in 2019). Overall working hours tended to decrease; however, interns worked the most (114 hours in 2016, 88 hours in 2019; P<0.001). Having 10 hours or more of break time has gradually become more common (P<0.001). Lunch breaks per week decreased from 5 in 2017 to 4 in 2019 (P<0.001). Trainees’ sense of educational deprivation due to physician assistants increased from 17.5% in 2016 to 25.6% in 2018 (P<0.001). Awareness of tasks and program/work achievement goals increased from 29.2% in 2016 to 58.3% in 2018 (P<0.001). Satisfaction with the learning environment increased over time, whereas satisfaction with working conditions varied.
The Medical Resident Act has brought promising changes to the training of medical residents in Korea, as well as their satisfaction with the training environment.
Keywords: Internship and residency; Perception; Personal satisfaction; Republic of Korea; Training support
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