The purpose of this study was to investigate the clustering pattern of four major lifestyle risk factors—smoking, heavy drinking, poor diet, and physical inactivity—among people with metabolic syndrome in South Korea. There were 2,469 adults with metabolic syndrome aged 30 years or older available with the 5th Korean National Health and Nutrition Examination Survey dataset. We calculated the ratio of the observed to expected (O/E) prevalence for the 16 different combinations and the prevalence odds ratios (POR) of four lifestyle risk factors. The four lifestyle risk factors tended to cluster in specific multiple combinations. Smoking and heavy drinking was clustered (POR: 1.86 for male, 4.46 for female), heavy drinking and poor diet were clustered (POR: 1.38 for male, 1.74 for female), and smoking and physical inactivity were also clustered (POR: 1.48 for male). Those who were male, younger, low-educated and living alone were much more likely to have a higher number of lifestyle risk factors. Some helpful implications can be drawn from the knowledge on clustering pattern of lifestyle risk factors for more effective intervention program targeting metabolic syndrome.

Introduction: In general, refugee doctors encounter difficulties in regularly practicing medicine in their host countries. In particular, many barriers impede the efforts of North Korean refugee doctors (NKRDs) who have settled in South Korea to acquire a medical license in the country. This study examines the experiences and opinions of NKRDs in their attempts to acquire permission to legally practice medicine in South Korea and the opinions of South Korean experts regarding this matter. Methods: In-depth interviews were conducted among 23 participants divided into 2 groups. The first group comprised 16 NKRDs recruited through snowball sampling, whereas the second group included 7 South Korean doctors experienced in operating programs assisting NKRDs in license acquisition. Results: All participating NKRDs perceived that they face grave difficulties at every stage of acquiring a South Korean medical license and, particularly, in gaining recognition for their educational credentials. Furthermore, South Korean experts expressed the necessity of supporting, establishing, and expanding a system in the country whereby NKRDs can acquire a medical license. Discussion: Strengthening and changing their clinical competency to meet South Korean standards is the best option for NKRDs to acquire a medical license. Furthermore, the study reveals that the government should eliminate the obstacles in medical license acquisition by NKRDs and support the latter in their efforts to improve and demonstrate their competency.