고대구로병원의 의료윤리 집담회 (Medical Ethics Grand Round)의 경험

More than 80% of medical schools in Korea (33 medical schools out of 41) provide medical ethics courses as a core curriculum in Korea. However, few residency programs offer medical ethics education as a graduate medical education. Since resident years are a critical period of socialization and professionalization of becoming doctors, ethics education in graduate medical education is far more important than in undergraduate medical education. In 2002, faculty members of the Department of Family Medicine at Guro Hospital, one of the three Korea University Medical Centers, organized medical ethics grand rounds as a part of graduate medical education. Residents for themselves selected cases to be presented and discussed for the grand rounds. The goals of the grand round are to recognize ethical dimension of medical practice, to discuss ethical issues embedded in cases among professions involved in medical practice, and to reach reasonable decision making by interprofessional discussion and ethical reasoning. The grand rounds were open to those who participate in patient care: physicians, nurses, pastors, nuns, social workers, medical students, nursing students, hospital administrators, and members of hospital ethics committees. Usually 50 to 80 people attended the grand round and participated actively in the discussion. Our experience of medical ethics grand rounds shows that ethics grand rounds can be an effective and practical method of ethics education for residents. The motivation of residents was high since they dealt with their patient cases, wishing to solve ethically complicated problems in the cases. Although physicians' perspectives were rather dominant, the interprofessional approach was fruitful for the participants from various professionals.