Background
Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation.
Methods
This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period.
Results
The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups.
Conclusion
Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

Citations

• The independent and moderator role of communicative health literacy on health, health behaviour and health care utilisation: a population based cross-sectional study
  F. Vincze, F.E.A. Israel, R. Ádány, É. Bíró
  Public Health.2025; 245: 105794.     CrossRef
• Behavioral health care provider’s beliefs, confidence, and knowledge in treating cigarette smoking in relation to their use of the 5A’s intervention
  Midhat Z. Jafry, Jayda Martinez, Tzuan A. Chen, Maggie Britton, Isabel Martinez Leal, Anastasia Rogova, Bryce Kyburz, Teresa Williams, Mayuri Patel, Brian J. Carter, Lorraine R. Reitzel
  Addictive Behaviors Reports.2023; 17: 100493.     CrossRef
• Developing Smoking Cessation Program for Female Smokers and Assessment of Its Impacts
  Kyung Hyun Suh
  STRESS.2023; 31(4): 189.     CrossRef
• Current status of health promotion in Korea
  Soo Young Kim
  Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
• Public Health Intervention for Smoking Cessation
  Soo Young Kim
  Korean Journal of Family Medicine.2021; 42(5): 343.     CrossRef

Background
Accreditation is an approach toward quality improvement which has been increasingly implemented in healthcare. This study aimed at developing a national functional accreditation model for primary healthcare with emphasis on family practice in Iran.
Methods
This mixed-method study utilizes a set of research methods purposefully. Initially, the reference models were used for benchmarking accreditation standards through a systematic review. Then, the primary accreditation standards were developed and then they were assessed and approved by the experts of the field via Delphi technique. In the following and after developing essential parts of the standards, the necessary changes in developed model were done according to the pilot test results.
Results
The results of systematic review suggested the superiority of accreditation models of the United States, Australia, Canada, and the United Kingdom globally; and the models of Jordan, Saudi Arabia, Lebanon, and Egypt in Eastern-Mediterranean region. Then, the primary standards including 39 functional standards with 231 measures were developed according to the benchmarked models, and were approved by the experts in Delphi-based study. In pilot test step, the compliance rate of developed standards by primary healthcare centers was calculated 61.61% and 26.37% for self-evaluation and external evaluation phases, respectively.
Conclusion
Regarding the comprehensiveness of developed accreditation model due to its focus on all functional dimensions and the consensus over the developed standards by the experts, it can be an underlying ground for the establishment and evaluation of functional improvement programs in Iranian primary healthcare system.

Citations

• Accreditation of primary health care services: A systematic review
  Babak Rastegarimehr, Ahmad Ahmadi Teymourlouy, Hasan Abolghasem Gorji
  Journal of Education and Health Promotion.2025;[Epub]     CrossRef
• The compliance of the training program for hospital accreditation surveyors in Iran with the international requirements: a mixed-methods study
  Tahmineh Poursaki, Lida Shams, Ali Maher, Farid Gharibi
  BMC Health Services Research.2025;[Epub]     CrossRef
• Challenges and Weaknesses of Leadership and Governance-related Health Policies in Iran: A Systematic Review
  Rahim Khodayari-Zarnaq, Khorshid Mobasseri, Shabnam Ghasemyani, Fatemeh Sadeghi-Ghyassi, Maryam Naghshi, Neda Kabiri
  Archives of Iranian Medicine.2024; 27(9): 508.     CrossRef
• ssessing the performance of comprehensive health care centers in Aradan district based on the national accreditation model
  Farid Gharibi, Jafar Jandaghi, Esmaeil Moshiri
  Koomesh journal.2021; 23(5): 617.     CrossRef

Background
The family, as the smallest social institution, has responsibilities across many functions, including maintaining family health. Increases in chronic diseases and life expectancy require more family support to prevent disease and implement treatment for family members with chronic diseases. Therefore, physician involvement in not only the treatment of diseases but also their prevention and rehabilitation is required In Indonesia. Hence, a new approach for physician involvement with families is required, especially with regard to comprehensiveness. This study aimed to develop a physician involvement program with the family model for primary healthcare in Indonesia.
Methods
A two-round Delphi method with family medicine experts from 17 of the highest accredited medical faculties in Indonesia as participants was conducted, and factor analysis performed thereafter. The items were considered relevant at ≤0.8 validity content ratio. The second step of this research is survey using e-questionnaire involving 101 primary care physician from all over Indonesia. They live scattered in several provinces in the main islands of Indonesia such Sumatra, Java, Kalimantan, Sulawesi dan Bali.
Results
Results showed an adequately measured sample and correlation for all items (Kaiser-Meyer-Olkin of sampling=0.821; Bartlett’s test <0.001). Seven dimensions were derived from results with eigenvalue of >1, and 25 items were filtered after determining the loading factor of >0.5. The Cronbach’s α for each factor varied from 0.602 to 0.829, and that for the total 25 items was 0.913, with a total variation documented as high as 66%.
Conclusion
A new physician involvement model with the family approach model, known as the “GENOGRAM model,” was developed, which consisted of seven dimensions and 25 items.

Citations

• Comprehensiveness in Primary Care: A Scoping Review
  AGNES GRUDNIEWICZ, ELLEN RANDALL, LORI JONES, AIDAN BODNER, M. RUTH LAVERGNE
  The Milbank Quarterly.2025; 103(1): 153.     CrossRef

Citations

• Hepatitis B vaccination status, knowledge and associated factors among healthcare professionals in Dongola, Sudan, 2024: a cross-sectional study
  Mogahid Mohamed Awad, Sami Altalib, Kamil M. Shaaban
  BMC Infectious Diseases.2025;[Epub]     CrossRef
• Hepatitis B in Healthcare Personnel: An Update on the Global Landscape
  Georgia B. Nikolopoulou, Ioannis Tzoutzas, Athanasios Tsakris, Helena C. Maltezou
  Viruses.2023; 15(12): 2454.     CrossRef
• COVID-19 vaccine hesitancy in Sana'a, Yemen
  Redhwan Ahmed Al-Naggar, Hisham Alshaikhli, Reyadh R. Al-Rashidi, Sharon Murtagh
  International Journal of One Health.2022; : 58.     CrossRef
• Prevalence and management of rubella susceptibility in healthcare workers in Italy: A systematic review and meta-analysis
  Francesco Paolo Bianchi, Pasquale Stefanizzi, Giusy Diella, Andrea Martinelli, Antonio Di Lorenzo, Maria Serena Gallone, Silvio Tafuri
  Vaccine: X.2022; 12: 100195.     CrossRef
• Prevention of Hepatitis B among Homeless People: Challenges for Vaccination in Brazil
  Thaynara Lorrane Silva Martins, Marcos André de Matos, Sheila Araujo Teles, Raquel Silva Pinheiro, Paulie Marcelly Ribeiro Carvalho, Márcia Maria de Souza, Camila Canhete Ferreira, Regina Maria Bringel Martins, Karlla Antonieta Amorim Caetano
  Journal of Poverty.2021; 25(4): 347.     CrossRef
• Promotion of healthcare personnel vaccinations among newly employed doctors and nurses: Evidence-guided strategy
  Hyo-Ju Son, Eunjung Lee, Se Yoon Park, Seungjae Lee, Hyohyun Hong, Eun Ju Choo, Tark Kim, Min Hyok Jeon, Shinae Yu, Jung Wan Park, Tae Hyong Kim
  Vaccine.2021; 39(26): 3480.     CrossRef
• Knowledge, Vaccination Status, and Reasons for Avoiding Vaccinations against Hepatitis B in Developing Countries: A Systematic Review
  Putri Bungsu Machmud, Saskia Glasauer, Cornelia Gottschick, Rafael Mikolajczyk
  Vaccines.2021; 9(6): 625.     CrossRef
• A Nationwide Survey on the Hospital Vaccination Policies in Korea
  Sun Hee Park, Mi Suk Lee, Sung Ran Kim, Yee Gyung Kwak
  Journal of Korean Medical Science.2020;[Epub]     CrossRef
• PERCEPÇÕES ACERCA DA IMPORTÂNCIA DAS VACINAS E DA RECUSA VACINAL NUMA ESCOLA DE MEDICINA
  Amanda Hayashida Mizuta, Guilherme de Menezes Succi, Victor Angelo Martins Montalli, Regina Célia de Menezes Succi
  Revista Paulista de Pediatria.2019; 37(1): 34.     CrossRef
• Immunization attitudes, opinions, and knowledge of healthcare professional students at two Midwestern universities in the United States
  Lauren L. Dybsand, Kylie J. Hall, Paul J. Carson
  BMC Medical Education.2019;[Epub]     CrossRef
• Vaccine refusal – what we need to know
  Regina Célia de Menezes Succi
  Jornal de Pediatria.2018; 94(6): 574.     CrossRef
• Measles vaccination status of nurses and associated factors during community measles outbreaks
  Kyung Mi Kim, Jeong Sil Choi
  Japan Journal of Nursing Science.2018; 15(3): 249.     CrossRef
• Comparison of three immunoassays for determination of immunity to rubella virus in healthcare workers
  Su-Yeon Jo, Kyung-Hwa Shin, Sun Min Lee, Eun-Young Jeong, Hyun-Ji Lee, Chulhun L. Chang
  Journal of Immunological Methods.2018; 463: 84.     CrossRef
• Vaccine refusal – what we need to know
  Regina Célia de Menezes Succi
  Jornal de Pediatria (Versão em Português).2018; 94(6): 574.     CrossRef
• Seroprevalence of hepatitis B virus infection and associated factors among healthcare workers in northern Tanzania
  Elichilia R. Shao, Innocent B. Mboya, Daniel W. Gunda, Flora G. Ruhangisa, Elizabeth M. Temu, Mercy L. Nkwama, Jeremia J. Pyuza, Kajiru G. Kilonzo, Furaha S. Lyamuya, Venance P. Maro
  BMC Infectious Diseases.2018;[Epub]     CrossRef

Citations

• Factors influencing contracting of residents with family doctors in China: a national cross-sectional survey
  Ning Zhao, Mei Gu, Jin Li, Haiyan Zhang, Jia Yang
  BMC Health Services Research.2024;[Epub]     CrossRef
• Public Awareness and Perception of Family Medicine in Jeddah, Saudi Arabia
  Bashair M Alshammrani, Renad O Aljuhani, Khadijah M Basaqr, Eman A Bin Mahfouz, Ebtisam M Alhawsawi, Reem Alqahtani
  Cureus.2022;[Epub]     CrossRef
• Aile Hekimliği Uygulamasını Daha Az Tercih Eden Kişilerin Uygulama Hakkındaki Bilgilerinin Değerlendirilmesi: Kesitsel Bir Çalışma
  Fatma Nur ÖZDEMİR, Can ÖNER, Huseyin CETİN, Engin Ersin ŞİMŞEK
  Turkish Journal of Family Medicine and Primary Care.2022; 16(4): 823.     CrossRef
• In the Name of Family Medicine: A Nationwide Survey of Registered Names of Family Medicine Clinics in Taiwan
  Ya-An Liu, Sally Cheng, Ya-Chuan Hsu, Po-Chin Yang, Hsiao-Ting Chang, Ming-Hwai Lin, Tzeng-Ji Chen, Li-Fang Chou, Shinn-Jang Hwang
  International Journal of Environmental Research and Public Health.2020; 17(11): 4062.     CrossRef
• Public's perception and satisfaction on the role and services provided by family physicians in Saudi Arabia: A cross-sectional study
  AmnahAli Abdulqader Elagi, BasemAmer Jaber, AlmontherHussain Ahmed Wassly, RubaMohammed Sallam Ahmed, FatimahAli Ahmed Bosily
  Journal of Family Medicine and Primary Care.2019; 8(10): 3282.     CrossRef

Citations

• Analysis of evidence appraisals for interventional studies in family medicine using an informatics approach
  Alain Nathan Sahin, Andrew Goldstein, Chunhua Weng
  Primary Health Care Research & Development.2019;[Epub]     CrossRef
• Current status of health services research in primary care in Korea
  Hee-Young Lee, Jong-Heon Park, Yong-Jun Choi
  Journal of the Korean Medical Association.2016; 59(11): 888.     CrossRef

Citations

• A New Role of Case Reports in Family Medicine and Primary Care
  Ki Dong Ko
  Korean Journal of Family Medicine.2021; 42(2): 181.     CrossRef
• Adecuación y calidad de las ecografías abdominales solicitadas por los profesionales de medicina
  Llorenç Caballería, Guillem Pera, Lluís Rodríguez, José Darío Casas, Dolores Miranda, M. Antònia Auladell, Isabel Buezo, Carmen Expósito, Ingrid Arteaga, Pere Torán
  Gastroenterología y Hepatología.2016; 39(8): 516.     CrossRef
• Acceptability and quality of abdominal ultrasound studies requested by medical professionals
  Llorenç Caballería, Guillem Pera, Lluís Rodríguez, José Darío Casas, Dolores Miranda, M. Antònia Auladell, Isabel Buezo, Carmen Expósito, Ingrid Arteaga, Pere Torán
  Gastroenterología y Hepatología (English Edition).2016; 39(8): 516.     CrossRef
• Epiglottic Cyst Incidentally Discovered During Screening Endoscopy: A Case Report and Review of Literature
  Seung-Hwa Lee, Duck-Joo Lee, Kwang-Min Kim, Kyu-Nam Kim, Sang-Wook Seo, Young-Kyu Park, Sung-Min Cho, Young-Ah Choi, Jung-Un Lee, Dong-Ryul Lee
  Korean Journal of Family Medicine.2014; 35(3): 160.     CrossRef

Background
Sleep is an essential restorative physiologic phenomenon. Impaired sleep results in significant negative effect to the health. Symptoms like sleep initiation difficulty, frequent awakening, severe snoring have related to poor sleep quality. We studied frequency and compared the characteristics of common sleep disorders at family practice.Methods: We surveyed patients over 18 years of age and their guardians who visited 16 familial practices for 6 days. We investigated sleep characteristics, frequency of sleep disorder and associated factors by questionnaires and analyzed by frequency analysis, Spearman's correlation coefficient, multiple logistic regression.Results: We enrolled 1,117 participants. Older participants were more likely to report early sleep onset and off time, short sleep duration. Mean number of awakening during a typical night is 1.69. Female complained difficulties in initiation and maintenance of sleep more than male. A total of 32.5% had these insomnia symptoms and related to hypertension, stroke, stress, arthralgia, depression, urological disorder. 31.1% had excessive daytime sleepiness, related to stress, arthralgia, depression. Loud snoring and gasp for breath showed positive correlation between male, high BMI. Disrupted sleep over 3 times was related to old age, female, diabetes, hypertension, stroke, stress, arthralgia, depression. Restless leg syndrome were high in elderly, high BMI, stress, arthralgia and depression.Conclusion: About one in three who visit in primary medical practice have sleep disorder symptoms like insomnia, daytime fatigue, snoring. 3% of them have gasp for breath, 8% have restless leg syndrome.

Citations

• Effect of Sleep Quality on Fatigue and Quality of Life : a Sasang Constitutional Medicine Perspective
  Ji-Eun Park, Sujeong Mun, Siwoo Lee
  Journal of Physiology & Pathology in Korean Medicine.2020; 34(1): 37.     CrossRef
• The Effect of Health-Related Habitual Consumption and Lifetime on Subjective Health of One Person Households: Focusing on Comparison between Non-One Person Households and Generations
  Ji Kyeung Ha, Seonglim Lee
  Family and Environment Research.2017; 55(2): 141.     CrossRef
• Insomnia: Causes and Diagnosis
  Dong Hyun Ahn
  Hanyang Medical Reviews.2013; 33(4): 203.     CrossRef
• Literature review of effect of work pattern (day shift and night shift) on worker's health
  Ki-Youn Kim, Man-Su Cho, Won-Mo Gal
  Journal of the Korea Safety Management and Science.2013; 15(2): 1.     CrossRef
• Prevalence and predictors of poor sleep quality in Korean older adults
  Jin‐Hee Park, Moon‐Sook Yoo, Sun Hyoung Bae
  International Journal of Nursing Practice.2013; 19(2): 116.     CrossRef

Background
Nowadays 2-year 'Compulsory Clinical Training Program' is on issue. The perception and opinions for the new training system of residents and interns may be essential to establish ideal postgraduate medical education. Methods: A questionnaire survey of postgraduate trainee from March to April 2008 was performed by person to person method. Gender, age, specialty, the location and the facility of the hospital, and 7 questions reflecting individual perception and opinions for the 'Compulsory Clinical Training Program' were reviewed. Results: Among in 1,314, 1,284 subjects completed the survey fully. We divided 1,284 sujects into 4 groups; Intern; Resident of Family Medicine; Resident of Internal Medicine or Pediatrics; Resident of other than Family Medicine, Internal Medicine and Pediatrics. About the vision for independent clinical skills through the 'Compulsory Clinical Training Program', most were negative. They were afraid of 'prolongation of current Internship' or 'unclear quality of the training course'. In case of setting the 'Compulsory Clinical Training Program', most chose additional resident courses for specialty. The main opinion about the ideal model of a primary physician was medical doctors who obtained primary care specialty. Conclusion: Most of the residents and interns think that the specialists of family medicine, internal medicine or pediatrics are suitable for primary care. And on wishing the additional residency course even after 'Compulsory Clinical Training Program', they doubt about the effi cacy of the new training system.

Background
The educational assessment of residents is very important in order to check their knowledge and to improve their ability. In case of family practice, the residents spend most of their training time in outside rotations with other specialities. Therefore, they are requested to be evaluated by each specialist after each rotation. To give more accurate assessment, we surveyed directly our family practice residents and family practice faculties. Methods: A questionnaire was sent to family practice residents and family practice faculties in 116 hospitals from May to June 2006. The response rate was 29% and 78%, respectively. Results: Among the total, 70.2% of family practice residents thought an assessment is necessary, but only 51.7% were evaluated. Overall, 90.4% of family practice faculties knew about the assessment of residents made by other specialists, and only 56.7% of faculties requested other specialists to assess their family practice residents. Conclusion: Most of the family practice residents and their faculties knew the need for assessment, but they complained there were no objectivity and the assessment tool was lacking. In order to solve this problem, it is urgent to develop a unified form and guidelines of assesment. (J Korean Acad Fam Med 2007;28:616-625)

Background
Consultation and referral are important characteristics of modern medicine which has become more segmented and more specialized. In particular, they give essential value to family practitioners to coordinate patients accordingly for proper care. This study analyzed the referred patients in family practices under Cheonan practice based-research network (CPBRN). Methods: The data was collected via questionnaire in ten family clinics under CPBRN system during the four weeks from June 15, 2006 to July 12, 2006. Results: The total number of referred cases was 103 (0.7%) out of a total of 14,466 office visits. Among the total, 68.9% of referred cases was physician-drived and 31.1% was patient-requested. The reason for referral were 'to get a second opinion of specialist' (34), 'high severity' (20), 'lack of examination tool' (18), 'lack of skill' (10) and 'no response to treatment' (2) in physician-drived cases, whereas in patient-requested cases, they were 'request for advanced hospital' (26) and 'want to meet specialist' (2). The patients were referred to tertiary hospital in 66.7%, secondary hospital in 15.9%, and other specialists of primary setting in 10.1%. Overall, 66.7% of the referred hospital was located in the city area. The main health problems of referred patients was divided into 'gastrointestinal' (17.5%), 'musculoskeletal' (13.6%), 'dermatology' (10.7%) and so on. The speciality consulting physicians were 'internal medicine' (34%), 'pediatrics' (13.6%), and 'orthopedic surgery' (10.7%) specialists. Conclusion: The referral rate of family practice in Korea was 0.7%. The main reason for referral was 'to get a secondary opinion of a specialist'. The most common referral problem was 'gastrointestinal'. 'Internal medicine' was the most frequently consulted specialty. (J Korean Acad Fam Med 2007;28:286-291)

Background
: Family practice academic dissertations are the product of family practice research in the school of medicine. This paper was intended to evaluate the status of family practice academic dissertations, analyze the basic data and suggest directions for family practice research in the school of medicine.

Methods : The total number of masters' and doctoral dissertations from 1992 to February, 2005 was 124. of those, 120 were collected. They were analyzed in terms of research area, subjects, collected data, methodology, and statistical methods.

Results : In terms of research area, health promotion/ disease prevention was the most common (42.5%). For study subjects, out-patients and in-hospital patients were the most prevalent (38.0%), followed by health promotion center visitors and community residents (28.7%). When it came to research methodology, analytic study was the most common by a wide margin (70.8%). Among analytic studies, cross-sectional studies were the most frequent, followed by case-control studies and cohort studies. The most commonly-used data were medical records and questionnaires.

Conclusion : Many advances have been made in research methodology and academic dissertation numbers since 1992. Many research topics, however, were not relevant to primary care. Much research was done in general hospital instead of primary-care facilities. These results must improve in the future.

Background
: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ).

Methods : Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ.

Results : The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P＜0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49∼82) in major depressive disorders, 70% (50∼90) in panic disorders, 70% (56∼83) in somatoform disorders, 84% (75∼92) in alcohol abuse, and 68% (62∼74) in any mental disorders. Patients' response to the PHQ was overall very receptive.

Conclusion : One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.

Background
: This study was conducted to survey current status of research and scholarly activity of residency programs and to evaluate quality of education.

Methods : Questionnaire on research and scholarly activity were sent to all residency training programs by regular mail on May 2003. The questionnaire included detailed characteristics of residency programs, current status of conferences, educations for research activities, degree of faculty involvement, and numbers of published papers and presentations for past year.

Results : A total of 103 residency programs answered the questionnaire. Most of the programs held journal review, book review, and clinical review in regular bases as scholarly activities. Smaller than 50% of the programs held case review, chart review, and psycho- social conference in regular bases. As research activity, 40 programs offered educations on epidemiology and statistics, and 55 programs held critical review of the literatures. Faculties involve actively in residents' research project in the process of designing research questions and selecting the subjects, but less actively in the process of gathering informations, completing manuscripts, and preparing presentations. Degrees of faculty involvement were smaller in the programs which are connected with medical school, had only 1 faculty, and educational experiences of the faculty were insufficient.

Conclusion : Current scholarly activities were active in various aspects, but psychosocial conference and chart audit should be encouraged. Special efforts are required in the research activities, especially in programs which were not connected with medical school and had only one faculty.

Background
: Family medicine clerkship gives undergraduate medical students the opportunity to integrate knowledge and skills taught in class. Impression from clerkship experience and preceptor's role model allow medical students to consider family medicine as a career choice. This study investigated the effect of family medicine clerkship on the preference for family medicine as a career choice in third-year medical students.

Methods : From July through December of 1995, one hundred third-year medical students attended family medicine clerkship at Hanyang University Medical School (HUMS). They were divided into 20 groups of 4∼6 students. Seven half-days of clerkship teaching were provided in a private family medicine clinic and 2 half-days, in an university hospital family medicine clinic. The score of preference for family medicine was measured using the 10 cm visual analogue scale.

Results : The subjects' mean age was 24.1 years. Eighty eighty percent of students were males. The mean score of preference for family medicine as a career choice were 3.2 for pre-clerkship, 6.9 for post-clerkship, and 7.0 at the end of third-year semester exam, respectively. The group preference score was different among groups. Sex, age, hometown, parents' occupation, inhabitation type, religion, and lecture exam score were not related to the preference score. Eleven percent of students hoped to specialize in family medicine in the future. The students' main conception of family medicine were 'primary care', and 'comprehensive care', in descending order.

Conclusion : Third-year family medicine clinical clerkship improved the students' preference for family medicine as a career choice. A continuous program needs to be developed to render positive effect into the final stage of resident selection.

Background
: Family doctor registration program was proposed several years ago and is still in discussion. The success of this program depends on attitude and acceptibility of people. This study was done to describe the attitudes of the people to the family doctor registration program.

Methods : We interviewed 657 adults who lived in Seoul, Bundang, Ilsan and Pyungchon with a preformed questionnaire. The questionnaire was pretested by five family doctor and trainee.

Results : About half of the respondents were favorable for family doctor registration program. The most importantly considered benefits of the program were continuity of care, telephone consultation and management of chronic disease. The most seriously considered drawbacks of the program were only single doctor available cost, and restriction of medical services. Over half of the respondents preferred internists as their treating doctor and family physician, pediatrician followed. About half of the respondents opposed on the fact that the family doctor was restricted to clinic-based practice. Half of the respondents intended to participate in the program and the rate of intention to participate in the family doctor registration program was related to their household income and favorable attitude to wards the program and marginally related to the number in a household, haring a regular doctor, their interest in health. The demographic variables did not influence intention to participate in the program.

Conclusion : Half of the respondents agreed to participate in the family doctor registration program, but others were negative to the principles of the program and cost, sharing.

Background
: As patients can go to specialists and family doctors do not have gate-keeping role, doctor-shopping is very popular in Korea. The introduction of family doctor registration program is proposed several years ago, and the debate is still being done about that issue. This study is to show the possession rate of regular doctor and to investigate the factors associated with it.

Methods : We interviewed 657 adults of Seoul, Bundang, Ilsan and Pyungchon with preformed questionnaire which included the questions about regular doctor and attitudes to the family doctor registration program. Respondents were sampled according to the age structure and population distribution of the cities.

Results : About half of the respondents had regular doctor. Internists were regular doctors of nearly half of the respondents and pediatricians 30.6%, oriental doctors 5.6%, general surgeon 4.4%, and family doctors 3.8%. About half of the regular doctors worked in primary clinic and 48.2% in hospitals. The most important reason choosing regular doctor was distance to the medical facilities. The most frequently provided service by regular doctor was vaccination (57.1%), the least was home visit (2.9%). Factors associated with the possession of regular doctors were residence area, sex of respondents, level of income and education.

Conclusion : Nearly half of the respondents had regular doctors and half of the regular doctors were internists and worked in primary clinics. The area of residence, sex, income level, level of education, and interest for health were related with the possession of regular doctor.

Background
: The purpose of this survey was to assess knowledge of the public on family medicine through the analysis of medical counseling by PC communication and compare them with that of internal medicine.

Methods : This survey analyzed the content of medical counseling by PC communication according to ICPC from Oct. 1996 to Jun. 1998. The survey was done by means of E-mail in Nownuri eyes and the selected medical departments were those of family medicine and internal medicine in Pusan National University Hospital.

Results : The total number of questions was 342, including 181 in the department of family medicine and 161 in internal medicine. In the analysis of medical counseling according to ICPC, there was a significant difference between family medicine and internal medicine in the reasons for questions by components(P<0.001). In family medicine, the reasons were symptoms, complaints(66.9%), diagnoses, diseases(18.8%), treatment, procedure, medication(17.2%), and diagnostic, screening, prevention(5.5%). In internal medicine, the reasons for questions were symptoms, complaints(64.6%), diagnoses, diseases(21.1%), treatment, procedure, medication(9.3%), and test results(4.3%).
There was a significant difference between family medicine and internal medicine in the questions by chapters(P<0.05). In family medicine, the questions about digestive system were 28 cases(15.5%), neurological system were 26 cases(14.4%), musculoskeletal system were 25 cases(13.8%), and unspecified were 25 cases(13.8%). In internal medicine, the questions about digestive system were 76 cases(47.2%), circulatory system were 21 cases(13.0%), and respiratory system were 15 cases(9.3%). The most common symptom was headache in family medicine and generalized abdominal pain in internal medicine.

Conclusion : There were significant differences in the age distribution, the reasons for questions, and the contents of questions between family medicine and internal medicine.

Background
: Esophagogastroduodenoscopy(EGD) is a useful diagnostic procedure and an important basic skill in family practice residency program. But currently we have no guidelines for EGD training in family practice residency program.

Methods : In March 1999, we mailed a self-administered questionnaire to the residency directors of all KAFM-accredited family practice residency program. 63 out of 109 programs responded to the questionnaire(57.8%)/

Results : Among the total of 63 hospitals that responded to the questionnaire, secondary hospitals were 55.6% and tertiary or university hospitals were 44.4%. 98.4% reported that their residents receive training to perform EGD. 57.1% of the total received training to perform EGD during internal medicine training. EGD was performed by family physicians in 38.1% of total family practice residency programs. In the mjority of these programs(34.9%, cumulative percent 74.6%), the minimal requirements for technical skills in EGD training were 50 cases and for both technical skills and cognitive skills at least 100 cases of EGD(41.3%, cumulative percent 79.3% was necessary). The most difficult component during EGD procedure seemed to be esophageal intubation followed by retroflexed maneuver and entering the pylorus in series.

Conclusion : To perform EGD in primary care, it is required for trainee to perform at least 50 cases of EGD under supervision in a family practice residency program.

Background
: Appropriate referral without failure, one of important health care services provided by primary care physicians, is very helpful not only to patients but also to the referring physicians. This study was performed to observe the rate of referral failure and to evaluate the factors related to referral failure.

Methods : from June 10 to October 31, 1997, all referrals made in the department of family practice in the Samsung Medical Center were studied. Structured questionnaires inquiring of referral initiator, physician's view of clinical severity and referral necessity, and the reason for referral were completed by referring physician whenever each referral was made. On the 60th day after referrals were initiated, medical records of the referred patients were reviewed to obtain the information on the demographic characteristics of the patients referred, the contents of referral, and the patient's attendance the specialist clinic after referral. Each referral was audited by five family physicians working at the Somsung Medical Center to examine the appropriateness of the time when the referral was initiated. The patients who did not attend at specialist clinic to which they were referred to were telephoned to ask about the reasons for the referral failure. Chi-square test and multiple logistic regression analysis used to evaluate the factors related to referral failure.

Results : During the study period, total of 477 referrals were made among 9.384 encounters and the referral rate was 5.08%. Fifty-eight patients failed to complete the referral process within predetermined period and the rate of referral failure was 12.16%. The risk of referrals failure was significantly low in cases whose referral time was assessed as appropriate(odds ratio=0.53). Female was a significant increasing the risk of referral failure(odds ratio=1.91). Being too busy(24.14%) was the most common reason for referral failure. Other reasons included improvement or resolution of symptoms(12.06%), information on the referral was not give(6.9%) and too great a distance the between hospital and the patients home(6.9%). Four patients forgot to attend the hospital.

Conclusion : Considerable proportion of patients being referred did not complete the referral process. Timely referral and sufficient discussion between physician and patient being referred seems to be necessary. to prevent referral failure.

Background
: Physicians who provide primary care should be trained specifically to manage the problems encountered in a primary care practice. This study was carried out to know the residents' concerns and problems during outpatient care by analysing case discussions as an outpatient teaching.

Methods : We used 533 records discussed by 3 residents' teams for 1 year. Of discussion contents, symptoms or diseases were classified into codes and chapters using the ICPC (International Classification of Primary Care) coding system and the main topics of discussion into 12 types. We compared data among 3 residents' teams and also between the discussed contents and the diseases of patients who vis-ited a family practice for 1 year. We used relative discussion ratio to compare data.

Results : Of 533 discussed records, 106 kinds of symptoms or diseases were used and the 20 most common kinds accounted for 61.7%. Contents about menopausal symptom/complaint were 47 records(8.8%) and was the most frequent. Digestive part was the most frequent chapter(22.0%). Distribution of discussed main topics were diagnosis(35.5%), medication(26.8%), other treatment(11.6%), followup(5.8%), etc. There was some difference among 3 residents' teams by chapters and topics.
Visiting patients were 3,436 persons with 79 kinds of symptoms and diseases and prior 20 kinds accounted for 86.6%. Visited patients were some what different with the discussed contents by chapters.

Conclusion : Contents of case discussion in ambulatory setting were some what different among each teams and more diverse than the visiting patients. The residents could exchange many informations and find problems during ambulatory care. We think case discussion can be a good method for outpatient teaching.