Status and Needs Analysis of Korean Medicine Doctors’ Continuing Professional Development

Abstract

Objectives

The present study aimed to analyze the status and needs of Korean Medicine doctors’ (KMDs) continuing professional development (CPD) and establish future improvement directions.

Methods

A cross-sectional survey targeting all KMDs was conducted between October 23 to November 5, 2024, obtaining 624 responses. The questionnaire was developed to assess satisfaction with continuing education and residency training, perceived efficacy on competency development, and improvement needs.

Results

While current CPD programs effectively enhanced optimal patient care competencies (highest-rated domain), approximately 40% of respondents indicated minimal improvement in social accountability and clinical management competencies. The most requested improvements were the expansion of practical training opportunities (63.0%) and curriculum improvement (37.0%). For residency training, respondents prioritized developing competency-centered curricula (65.0%) and standardized educational programs across training hospitals (63.3%).

Conclusion

Findings indicate that KMDs desire increased practical training opportunities, competency-based standardized curricula, and expanded scope of practice through institutional support. Establishing competency frameworks across clinical departments and strengthening competencies required in modern healthcare environments are essential for advancing Korean Medicine practice.

INTRODUCTION

Continuing professional development (CPD) is a fundamental requirement in today’s rapidly evolving healthcare environment. Healthcare professionals must engage in lifelong learning to effectively adapt to the advancing medical knowledge, evolving clinical guidelines, and emerging medical technologies [1, 2]. CPD is the structured process by which professionals sustain and enhance their knowledge, skills, and competencies after their initial professional education, thereby directly impacting patient safety and the quality of care they receive [3, 4]. Specifically, CPD for healthcare providers has been linked to improved patient outcomes and measurable changes in practitioners’ behavior, including increased adaptability to new clinical practices [5, 6].

In Korea’s dual medical system, Korean Medicine doctors (KMDs) are classified as medical professionals, alongside conventional physicians and dentists, practicing traditional medicine [7]. Furthermore, modern KMDs use the International Classification of Diseases for patient diagnosis, and their clinical settings have recently undergone substantial transformation, incorporating advanced diagnostic devices and medical technologies [8-12]. These shifts in clinical practice underscore the growing demand for continuous learning and professional development among KMDs. Currently, KMDs must complete 8 hours of annual continuing education for regular license registration, overseen by the Association of Korean Medicine under the authority of the Ministry of Health and Welfare [13].

However, current educational programs are predominantly designed and implemented from the providers’ perspective, inadequately addressing the genuine needs and preferences of KMDs as learners. In professional education, it is critical to consider the learning styles and educational needs of the learners [14]. Although satisfaction surveys are conducted after CPD programs for KMDs, the results remain undisclosed, and their educational needs have not been systematically assessed. Educational needs have only been partially reported and limited to specific topics such as infection control [15], blood test utilization [9], and ultrasound training [10, 11]. Therefore, this study aims to comprehensively investigate the current status and needs of postgraduate education for KMDs through a nationwide survey to inform and guide future improvements in CPD. The results of this study can contribute to the establishment of an effective learner-centered CPD system, laying the foundation for enhancing the expertise of KMDs and the qualitative advancement of Korean Medicine (KM) healthcare services.

MATERIALS AND METHODS

1. Survey design

Two researchers (one KMD and one doctor of education) drafted the questionnaire based on the educational program evaluation model, encompassing key domains based on established educational evaluation models: reaction, learning, behavior, career planning, and self-efficacy [16]. The preliminary survey was reviewed for content validity by a panel of seven experts, comprising KMDs and doctors of education with research experience in KM education. The panel evaluated each item’s relevance, clarity, and appropriateness through qualitative assessment. The questionnaire was revised iteratively through group discussion based on expert feedback until consensus was reached on the final version. The final questionnaire comprised 78 questions in 7 sections: 1) Demographic characteristics, 2) Satisfaction with continuing education, 3) Perceived effectiveness of continuing education on professional competency development, 4) Suggestions for improving continuing education, 5) Satisfaction with residency training experience, 6) Perceived effectiveness of residency training on professional competency development, 7) Suggestions for improving residency training programs (Supplementary File 1).

Individuals who did not consent to participate were automatically prevented from proceeding with the survey. The questionnaire was entered into the online survey platform Moaform (Qoom Networks Inc., Seoul, Republic of Korea). The online survey was designed to allow only one response per individual. A pilot test was conducted by the researchers to assess the questionnaire’s clarity and completeness.

2. Participants and recruitment

The survey was sent via email to all registered KMDs within the Association of Korean Medicine. The questionnaire was disseminated to the entire population of registered KMDs, without sampling. The survey was conducted between October 23, 2024, and November 5, 2024. The total number of registered KMDs at the time of the survey was approximately 26,000. A reward worth 3 USD was given to 200 participants: the first 100 and 100 randomly selected participants who completed the survey.

3. Ethical considerations

The Institutional Review Board of Dongguk University Bundang Oriental Hospital (DUBOH 2024-0008) approved the study as exempt from review. The email with the survey link explained the purpose of the survey, indicated that the supplied data would solely be utilized for research purposes, and assured that the results would remain confidential. The survey was designed exclusively for individuals who voluntarily consented to participate in the study. The survey was conducted anonymously, and contact information collected for participation rewards was deleted immediately upon the conclusion of the survey and the distribution of the rewards. The survey’s raw data was exclusively accessible to one researcher, and the results were shared confidentially with the researchers.

4. Analysis

Data were analyzed using Microsoft Excel 16 (Microsoft Corporation, Redmond, WA, USA) and R statistical software (version 4.4.2; R Core Team, 2025). Incomplete survey responses were excluded from the analysis to ensure data integrity. Descriptive statistics were utilized to summarize the survey results as frequencies and percentages. The impact of CPD programs on enhancing the five core competencies of KMDs was similarly analyzed using a four-level scale (1 = hardly improved, 2 = slightly improved, 3 = greatly improved, 4 = very greatly improved). Chi-square tests were performed to assess whether respondents’ demographic characteristics influenced their responses to key survey items and to identify significant perceptual differences among various subgroups of KMDs. All statistical tests were two-sided, and p < 0.05 was considered statistically significant. The survey’s open-ended responses were analyzed using thematic analysis, where recurring patterns were identified, coded, and systematically organized into significant categories to capture key themes across participants’ responses.

RESULTS

1. Demographic characteristics

A total of 626 responses were collected. Following the exclusion of two incomplete responses, 624 were included in the final analysis. The survey was distributed to approximately 26,000 registered KMDs, yielding a response rate of 2.4% (624/26,000). Among the 624 participants, 75.5% (n = 471) were male and 24.5% (n = 153) were female. The most frequently reported range of work experience was 5 to 10 years (20.0%). Based on employment type, self-employed physicians constituted 48.4% (n = 302), while salaried physicians comprised 28.4% (n = 177). Basic science and clinical faculty physicians represented 2.9% (n = 18) and 6.7% (n = 42) of the respondents, respectively. Furthermore, most participants, 92.9% (n = 580), were employed in healthcare institutions, whereas 7.1% (n = 44) worked in non-healthcare settings, including research institutions and universities. Among the respondents, 38.0% (n = 237) had participated in a residency training program, while 62.0% (n = 387) had not (Table 1).

Table 1.

Demographic characteristics of participants

	N	%
Sex
Male	471	75.5
Female	153	24.5
Career years
< 1	14	2.2
1 to < 2	29	4.6
2 to < 5	67	10.7
5 to < 10	125	20.0
10 to < 15	107	17.1
15 to < 20	96	15.4
20 to < 25	92	14.7
25 to < 30	39	6.3
≥ 30	55	8.8
Occupation
Self-employed physician	302	48.4
Salaried physician	177	28.4
Basic sciences faculty	18	2.9
Clinical faculty	42	6.7
Intern or resident	26	4.2
Public health officer	33	5.3
Military doctor	4	0.6
Researcher in KM	9	1.4
Research assistant (full-time graduate students, etc.)	7	1.1
Others (KMDs in government positions, lawyers, etc.)	6	1.0
Type of medical institution
KM clinic (non-specialized)	340	58.6
Specialized KM clinic	31	5.3
Non-university KM hospital	77	13.3
Nursing hospital or Western Medicine hospital	35	6.0
Public healthcare institution	3	0.5
Public health center/branch office	32	5.5
Military hospital or medical office	2	0.3
University KM hospital	58	10.0
Others	2	0.3
Experience in KM intern or residency training program
Yes	237	38.0
No	387	62.0

KM, Korean Medicine; KMD, Korean Medicine doctor.

2. Status and effectiveness of CPD programs

Over the past three years, respondents primarily participated in continuing education programs through various channels. Specifically, 33.5% attended local branch education organized by regional chapters of the Association of Korean Medicine, 30.4% participated in the National Korean Medicine Academic Conference hosted by the Society of Korean Medicine (SKOM), and 13.9% attended academic conferences held by its affiliated societies (13.9%) (Fig. 1). When assessing satisfaction with the most frequently completed continuing education programs over the past three years, 78.5% of respondents reported being satisfied with how well the programs addressed learner needs and offered diverse educational content. Furthermore, 63.5% indicated that the knowledge gained through these programs had a positive impact on their professional capabilities (Supplementary File 2). Regarding the perceived effectiveness of these programs in enhancing the five competency domains for KMDs, “optimal patient care” was rated highest, followed by “professionalism enhancement,” “effective communication skill,” “fulfillment of social accountability,” and “efficient clinical management” (Fig. 2). Regarding the appropriateness of continuing education expenses, 59.1% of respondents expressed satisfaction, whereas 40.9% responded negatively.

Figure 1.

The most common type of continuing education that respondents have taken in the last three years. AKOM, Association of Korean Medicine; SKOM, The Society of Korean Medicine; AFMC, The Armed Force Medical Command; MOHW, Ministry of Health and Welfare; APKOM, Association of Public Health Doctors of Korean Medicine; KM, Korean Medicine; KIOM, Korea Institute of Oriental Medicine; KOHI, Korea Human Resource Development Institute for Health & Welfare.

Figure 2.

Impact of continuing education on improving the five competencies of Korean Medicine doctors.

3. Improvement needs for the CPD system

When asked about potential improvement to the continuing education programs most frequently completed over the past three years (multiple responses allowed), respondents identified the following key areas: Expansion of practical training opportunities (63.0%), improvement of theoretical educational content (31.4%), systemic adjustment, such as revising the maximum credits allowed per session and year (28.7%), and enhancement of the selection process for accredited continuing education institutions (13.0%) (Fig. 3). Regarding whether continuing education providers should be diversified beyond the current range of institutions, 75.5% responded positively, while 24.5% opposed such expansion.

Figure 3.

Improvement measures for the KMD continuing education programs (multiple responses allowed).

For those who selected “Others” as a category for recommended improvements, thematic analysis revealed several suggestions. These included offering more online/non-face-to-face learning options, reducing program costs, curriculum systematization, focusing more specifically on KM content, diversifying educational topics, providing supplementary materials, enhancing teaching methods, and improving accessibility for academic writing (Supplementary File 3).

4. Professional development needs for duty expansion

A total of 85.9% endorsed enhancing the connection between basic education in KM colleges/graduate schools and postgraduate education, encompassing the alignment of competency levels and responsibilities. Regarding the establishment of the KMD role that defines the virtues and roles desired by modern society, 88.3% expressed concurrence, while 91.8% endorsed the creation of medical ethics for KMDs that could serve as the legal and institutional framework for KMDs’ responsibilities. When respondents were surveyed using ranked items to identify solutions for enhancing KMDs’ competencies and expanding their scope of practice, curriculum improvement was most frequently selected as the top priority (increasing clinical education hours and incorporating training on modern medical devices and techniques) (37.0%). This recommendation was followed by license system improvement (redefining the scope of KMD duties to better reflect current clinical realities) (23.4%). The most frequently selected second-priority reform areas were improvement of the health insurance system (expansion of covered/non-covered items) (24.7%) and educational system reform (reorganization of the academic system, student internship system) (21.7%) (Fig. 4). Regarding a proposed 8-year cross-training program (comprising 6 years of KM education followed by 2 years of Western medicine) as an educational system reform measure to enhance KMDs’ competencies and broaden their scope of practice, 77.2% of respondents expressed support. Respondents with less than 10 years of experience were significantly more supportive of the 8-year cross-training system compared to those with 10 or more years of experience (p = 0.004).

Figure 4.

Prioritized solutions for enhancing Korean Medicine doctors’ competencies and expanding scope of practice (ranked selections up to 7th priority).

5. KM residency program status and improvement needs

Among respondents with residency program experience, 5 were current interns, 32 had completed their internship, 26 were residents in training, and 174 were certified specialists. The distribution of KM specialized residency departments was as follows: KM Internal Medicine (n = 78, 37.9%), KM Acupuncture & Moxibustion Medicine (n = 48, 23.3%), KM Obstetrics & Gynecology (n = 18, 8.7%), Sasang Constitutional Medicine (n = 16, 7.8%), KM Pediatrics (n = 13, 6.3%), KM Neuropsychiatry (n = 13, 6.3%), KM Rehabilitation (n = 11, 5.3%), and KM Ophthalmology, Otolaryngology & Dermatology (n = 9, 4.4%). The most common reasons for choosing a residency program (multiple responses allowed) included “to deepen subject-specific knowledge and skills” (68.8%), “gain clinical experience in advanced hospitals” (54.0%), “consider diverse career paths (universities, research institutions, university hospitals, employed positions)” (44.7%), and “enhance understanding of collaborative treatment processes and Western medicine procedures” (35.4%) (Table 2).

Table 2.

Reasons for choosing a residency program (multiple responses allowed)

	N	%
Developing knowledge and skills in a specific subject	163	68.8
Gaining diverse experiences with patients in advanced hospitals	128	54.0
Considering various future work options (universities, research institutions, university hospitals, employed positions, etc.)	106	44.7
Enhancing understanding of collaborative treatment processes and Western medicine procedures	84	35.4
Strengthening competitiveness in employment and job searching processes	64	27.0
Preparing for the possibility of differentiated fees for specialists	40	16.9
To gain experience in professional life	25	10.5
Others	3	1.3

Overall, respondents reported higher satisfaction levels than dissatisfaction across all survey items. The highest satisfaction was reported for “improved work abilities” (83.9%). Nonetheless, specific aspects of the program received notable dissatisfaction, including “lack of alignment with learner needs” (44.3%), “limited diversity in educational content” (41.8%), and “weak integration with pre-resident education” (41.8%). When evaluating the residency’s impact on KMD competencies, “optimal patient care” received the highest rating of “very much improved” (33.3%), whereas “performing social accountability” had the highest rate of “hardly improved” responses (19.8%). Regarding areas for improvement in residency training (multiple responses allowed), frequent selections were “Introduction and application of KMD-based curriculum based on core competencies structured around knowledge, skills, and attitudes” (65.0%) and “development and implementation of standardized educational programs applicable across all KM training hospitals” (63.3%) (Supplementary File 4).

DISCUSSION

1. Summary of findings

This study aimed to examine the current status and educational needs of KMDs’ CPD. We conducted a nationwide survey targeting all KMDs and collected 624 valid responses. Among the five core competency domains, respondents most frequently reported that the continuing education programs contributed to enhancing the “optimal patient care.” However, approximately 40% of respondents indicated minimal improvement in “social accountability” and “clinical management” competencies. To address these gaps and broaden KMDs’ competencies and scope of practice, curriculum enhancement and license system reform were prioritized. Respondents with residency program experience reported greater satisfaction than dissatisfaction with their training; however, there were high dissatisfaction rates regarding the alignment of programs with learner needs and the provision of diverse educational content, highlighting the need for competency-based standardized educational programs.

2. Debates

The survey identified “expansion of practical training opportunities” as the most frequently suggested improvement for KMDs’ continuing education, consistent with international research trends. Although CPD is primarily conducted in one-way educational formats such as conferences, interactive educational methods that encourage clinical reflection and facilitate skill practice are recognized as more effective in improving health outcomes [17]. However, expanding practical education requires institutional support, including adequate infrastructure, faculty resources, and standardized training materials. It is essential to define the competencies and healthcare objectives attainable through CPD, systematically design educational topics and methods including practical training, and implement them with support from the Korean Medicine Association and government authorities [18]. Specifically, customized methods that account for learner characteristics and techniques while addressing cost-effectiveness are essential for enhancing educational outcomes and clinical relevance [19].

Discussions regarding the expansion of KMDs’ responsibilities emerged as a prominent finding in our survey. Respondents identified the enhancement of the curriculum and license system as their primary suggestions for enhancing KMDs’ competencies. Specifically, they emphasized the need for increasing clinical education hours and instructions on various modern medical devices and techniques, as well as refining the scope of KMD responsibilities to reflect clinical realities. The Medical Service Act in Korea stipulates that KMDs may “administer Korean Medicine treatment and provide health guidance based on Korean Medicine”; however, it lacks explicit clarification regarding the “unauthorized medical practice” that KMDs are prohibited from [13]. This legal ambiguity has resulted in ongoing conflicts and disputes among medical professionals regarding KMDs’ use of modern medical devices [10, 20].

The 77% support rate for introducing an 8-year cross-training system between Korean and Western medicine indicates that KMDs are willing to embrace innovative changes in the educational system to expand their professional practice. The higher support rate among less experienced groups indicates younger generations’ recognition of the need to respond to changes in the healthcare environment. This proposed educational system could reference Taiwan’s dual license program. Taiwan employs a dual medical system comprising traditional and conventional medicine, similar to Korea; it offers a single license program for traditional medicine and an 8-year dual license program, allowing graduates to obtain a traditional medicine and a Western medicine doctor’s license [7]. In Korea, obtaining a dual license requires graduating from a Korean medicine college and a Western medicine college, which requires two separate admission processes and typically over 10 years of education, resulting in a limited number of dual-qualification practitioners.

KM residency training presently lacks standardized educational programs that are consistently applied throughout all training hospitals. This study revealed that although numerous respondents believed residency training enhanced their professional competencies, improvements are needed in addressing learner needs (44.3% dissatisfaction), offering diverse educational content (41.8% dissatisfaction), and integrating with undergraduate education (41.8% dissatisfaction). The Accreditation Council for Graduate Medical Education in the United States has established six core competencies, including patient care, interpersonal and communication skills, and professionalism, utilizing these as criteria for systemic education and evaluation of residency programs [21]. To address the high demand identified in this study for the creation of standardized educational programs (63.3% support) and the implementation of competency-based curricula (65.0% support), it is essential to clearly define basic competencies applicable across all eight clinical departments of KM alongside department-specific competencies and to formulate systematic residency education curricula.

International experiences from other East Asian countries utilizing traditional medicine systems provide helpful advice for enhancing Korean Medicine CPD. China requires 25 credits annually across two course categories, while Taiwan stipulates 180 credits over six years, significantly exceeding Korea’s current requirement of 8 credits annually [22]. Furthermore, postgraduate residency training in Korea is voluntary after graduation, but both China and Taiwan require mandatory one-year internships for national licensure, followed by structured residency programs. China implements a three-year standardized residency training with additional specialty certification pathways, whereas Japan permits Western medicine doctors to attain Kampo specialization through a three-year training program [22]. These standardized training frameworks, especially China’s competency-based model, may guide Korea’s development of common core curricula and department-specific programs, addressing the substantial demand (65.0% support) identified in this study for competency-centered educational reform.

3. Limitations of the study

Although this study targeted all KMDs, the response rate was relatively low at 2.4% (624/26,000), limiting the generalizability of our findings. This low response rate is a common challenge in surveys targeting KMDs [20, 23] and may lead to potential selection bias, as respondents with stronger opinions on continuing education might have been more motivated to participate. Additionally, it is possible that non-respondents had different educational needs or priorities regarding CPD improvement.

This study’s reliance on self-reported data might include recollection and social desirability biases, thereby compromising the accuracy of reported satisfaction levels and perceived educational efficacy. Furthermore, the cross-sectional design of this study captured KMDs’ perspectives at a singular point in time; future longitudinal studies would be valuable to monitor changes in the system and content of KMD continuing education programs and how KMDs’ perceptions and needs evolve. Future studies should incorporate objective assessment methods, including performance metrics or clinical outcome measures, to complement self-reported data and provide a more comprehensive evaluation of the effects of continuing education on KMDs’ clinical competencies and patient care.

The questionnaire development process lacked statistical reliability and validity testing; items were finalized based on qualitative content validity evaluations by experts. While the small financial incentive might have improved response rates, it could have also resulted in less thoughtful responses, primarily motivated by the reward. Furthermore, the survey’s dissemination through email suggests a higher participation rate among respondents who are accustomed to online settings. This study is the first survey to investigate satisfaction and perceived effectiveness regarding KMDs’ continuing education and residency training programs. This study employed various question formats, including multiple-choice, ranking, and open-ended questions, to comprehensively collect respondents’ opinions on improving KM CPD.

4. Implications for future research and education

future research should focus on the systemic design of traditional medicine CPD programs and the creation of standardized assessment tools to evaluate effectiveness through pre/post-tests of clinical knowledge and validated surveys assessing changes in practice behavior and patient outcomes. Comparative analyses of CPD systems, educational content, and methodologies in East Asian countries employing traditional medicine—specifically China, Taiwan, Japan, and Korea—are essential to discern effective models and innovative strategies that may enhance the Korean system. Residency training in traditional medicine should clearly define essential clinical experiences, establish department-specific competencies, and implement systematic educational programs based on these criteria.

For immediate implementation, continuing education providers should restructure their programs to include additional practical training opportunities and update theoretical content based on the competency domains that demonstrated minimal improvement in this study, specifically social accountability and clinical management. The Association of Korean Medicine should establish a standardized competency-based framework for accrediting continuing education programs and formulate guidelines for evaluating their effectiveness. KM colleges should coordinate undergraduate and postgraduate curricula to ensure consistent competency development throughout KMDs’ careers. Furthermore, policymakers should implement regulatory changes to clarify the legal responsibilities and permissible use of modern medical technologies by KMD practitioners based on the needs identified in this survey, while prioritizing patient safety and quality of care.

CONCLUSION

This study demonstrated that current CPD programs effectively enhance optimal patient care competencies; however, they require substantial enhancement in practical training opportunities and greater diversity of educational content. The strong support for expanding the scope of practice, implementing competency-based education, and establishing standardized residency training programs demonstrates KMDs’ willingness to embrace innovative changes in their professional development. To address these requirements, it is imperative to establish competency frameworks across clinical departments, expand practical training within the existing CPD system, and strengthen essential competencies for KMDs to meet modern healthcare demands through institutional support to advance KM practice.

SUPPLEMENTARY MATERIALS

Supplementary data is available at https://doi.org/10.3831/KPI.2025.28.3.201.