Saturday, December 27, 2008

E2 Visa Health/Medical Check for Renewing a Contract -- One of the things I truly dislike about living in Korea

Proviso: The following description of a medical/health check in Korea is based on ONE individual's experience. Every foreign teacher who gets a medical check done in Korea will have a different experience due to a wide variety of factors. The only way you can prepare is to bring a Korean co-teacher or friend who speaks Korean fluently with you to the clinic. Have every document (alien registration card, passport, etc) with you in case you're asked for it. And most importantly--check your assumptions and expectations at the door because it's very likely at least ONE part of the process will be different than how things are done in your home country and culture.

About 2 weeks ago I had to go get a medical check. The university I work at makes all of its faculty go every year. I considered trying to explain that I had ALREADY gone for a medical check this past February 2008 when I was applying for my E2 Visa . . . but because I didn't keep a copy of the medical report, and because EVERYBODY IS DOING IT (being the individual who doesn't go is not an option), I just gave up and went. The one good thing about the whole situation was that it was free.

I've heard medical/health check fees in Korea run from about 30 000 up to 75 000 . . . depending on where you are at the time, and who is running the medical check. The ludicrous truth is that there is NO SET STANDARD of what tests are done at these medical checks. Yet the supposed public concern of the government and parents of Korean students to safeguard their children who are being taught by foreign teachers doesn't seem to have developed and implemented across the nation a standard set of criteria that must be tested. Even the HIV and drug test are missed by doctors running the tests . . . oh, and IMMIGRATION officers . . . which totally blows my mind.

Last February when I was getting all of my paper work processed at the immigration office I had to insist 3 times that the officer check my medical documents to make sure that they were accurate and fulfilled the E2 Visa criteria of HIV test and drug test. The medical report was MISSING that information! If I hadn't insisted on it being checked I wonder if the error would have been found. So the officer called the international clinic in Incheon International Airport where I had had my medical check done and asked the nurse to confirm over the phone (something else that blows my mind--you can do that? How do they KNOW that the person calling is a doctor/nurse/immigration official and not one of my students or any Mr. Kim that feels like finding out my medical info?) that the tests had been done, and that I had passed . . . unbelievable.

Anyways, I went to this four story clinic that specializes in doing medical checks with a coworker and friend. I hadn't been to the clinic in Chuncheon that apparently specializes in doing medical health checks before so I took some pictures.

My friend and I had tried to be proactive by getting the form we thought we had to fill out BEFORE going to the clinic. We got a copy and had the more difficult parts of it translated into English.

These are some of the questions LOOSELY TRANSLATED into English.

1) Have you had a serious illness/disease in the past? Do you have one now?
If so, please list what it/they are.

2) Has anyone in your family ever died of a serious illness or disease? If so, please list who and what they died of.

3) Do you have any disease/s you worry about now? If so, please write about them.

4) What do you prefer to eat on a daily basis?
a) vegetables only
b) meat only
c) vegetables and meat

5) How often do you drink?
a) rarely
b) once a month
c) 1-2 times a week
d) 3-4 times a week
e) almost every day

6) If you drink SOJU (as opposed to other kinds of alcohol, like there's a difference), how much do you drink in one sitting?

I found #6 VERY INTERESTING. Why is there a difference between beer/wine/whiskey and soju? Is drinking soju generally considered to be 'less harmful' because it's a Korean traditional drink? I suspect that a government sponsored public awareness campaign might be desperately needed in Korea about drinking alcohol and the health related consequences.

7) How much do you smoke?

8) If you smoke, how much do you smoke every day?

9) How long have you been smoking?

10) How often do you exercise every week?

11) Have you felt exhausted recently?

I carefully filled out the form and brought it with me thinking that I was prepared and everything would go smoothly--DOH! You'd think that I'd know better after nearly four years of living in Korea that NOTHING EVER GOES SMOOTHLY when I have to get something done for a government agency in Korea . . . n-o-t-h-i-n-g.

This (below) is the main waiting room on the first floor. You fill out forms (four pages apparently, but I was never asked to complete all of the pages after handing in my one page form I had brought with me--not sure why) in Korean and then after waiting you get called up to the desks at the front.

The doctor (?), technician (?), clerk (?) who took my information had a hard time reading my name printed clearly in English (that or he had never heard of the name "Jason" before so didn't know how to type it into his computer in Korean). So I handed him my alien registration card and medical insurance card. He typed in some info on the computer and then handed me a clipboard with my forms on it and said in Korean to go to the second floor.

On the second floor I saw this long counter with two technicians behind it. There were about 30 seats with several Koreans waiting in them. I then realized with a growing sense of dread that EVERYTHING I was about to get done on this floor would be open to the viewing pleasure of the Koreans waiting in the seats . . . this is one of the cultural differences that I really can't get past. I deal with it--but I don't like it.

The second floor is where you get to pee in a cup and have your blood taken. Luckily the first task can be done in the bathroom . . . lol, sigh.

I took a few pics and then chatted with my friend while waiting for my name to be called.

The technician on the right was calling out names and handing out paper cups with your name and info on a label pasted onto the side of the cup. You were then expected to go to the bathroom and fill it.

I didn't understand who I was supposed to give my sample cup to after completing the trip to the bathroom. I was confused and alarmed about walking around with a paper cup full of . . . and when I walked up to the counter to give it to the technician he gestured towards the back of the room and said something in Korean that was way too fast for me to understand . . .

Walking towards the back of the room with a total sense of "cultural vertigo" ('a dizzying sensation of tilting within stable surroundings or of being in tilting or spinning surroundings') was odd for me because I generally think I handle cultural differences and shocks fairly well now . . . well, nope, not this time. "Cultural vertigo" is something I coined just for this posting . . . I think it articulates what I was feeling a lot better than "culture shock."
UPDATE: I realized that I said (above) "cultural vertigo" is something I coined just for this posting" without doing a Google search to see if anyone else has put those two words together and defined it in the same way or something similar . . . here is what I found.


2. NewsCube: "Cultural Vertigo: Islam and European Immigration" (S01E03)

3. and there's the third search result . . .

Life in these British Isles

Cultural vertigo, plus All-new featured Scottish word

"Fellow blogger Hadashi introduced me to this term, cultural vertigo, of which I am digging on. This is the feeling of which I blogged about so unsuccessfully in the last few entries. I like this cos it really did feel like a dizziness. Hadashi's husband is in the same boat as me, living in a culture outwith his own. It makes me wonder if this is his choosing -- if he had a chance, would he move back home?"

4. Sketchpad Cultural Vertigo blog posting

"Last Sunday we went over to the hotel to enjoy brunch, but it just wasn't the same. I felt totally uncomfortable, uneasy, irritated. I felt my blood pressure rising. The food was great, as usual. The staff was helpful and attentive. I knew something was wrong - my body kept trying to tell me something was wrong - but I just couldn't figure out what it was. Normally I would just brush it off - forget about it, but this had me worried. Our infrequent brunch treats mean a lot to us, and I didn't want to lose that. The rest of the day I kept replaying the brunch back, over and over again, in my head - trying to figure out the puzzle. What was wrong?"

Anyways . . . I think some people expect blogs to use standards of academic writing and research because the blog content is 'published'--the thing about that is that a blog is to a large degree an online journal or diary. For myself, and my own blog, my writing style, and the topics I sometimes engage with, can have an 'academic tone' and some of the readers of my blog are 'academics,' professors in Korea and overseas (Canada for example) and so on . . .

So for the sake of defining what I personally mean by "cultural vertigo," within the context and medium of my personal blog on the Net, it is this,

"cultural vertigo" is a combination of the physical sense of "vertigo" ('a dizzying sensation of tilting within stable surroundings or of being in tilting or spinning surroundings') within the context of a cultural experience in a foreign country/socio-cultural moment. Add the element of 'cognitive dissonance' to the definition and this is what I mean when I use the term.

So, in one sentence my own definintion of 'cultural vertigo' is "the mental and physical sensations of stable ideas, expectations, and assumptions being turned upside down and inside out, if not completely ruptured by an experience within a foreign culture to the point of having lost one's sense of equilibrium or equanimity"

Since this blog is not an academic paper or being written with the express intent of conveying academic info I'm not inclined to try to trace the etymology of the term 'cultural vertigo'--especially online . . .

Arriving at the back of the room I saw this setup--and experienced one of the biggest culture shocks I've had in Korea so far.

This is where you're supposed to leave your paper cup after depositing your sample . . . some people might say, "What's the big deal?" And I'd reply, "Uhm, hygiene issues, bio-hazard issues, privacy and confidentiality issues . . . HELLO?!"

At this point I need to stress that I hadn't seen this kind of setup before in Korea when getting a medical check done. In the Incheon international medical clinic there was also a table like this but it was behind a counter inside a lab. A technician took my cup from me that time and put it in a semi-secure area out of the way of the general public . . .

After dealing with my cultural vertigo I waited for my name to be called to have my blood drawn. With about 20 Koreans watching me I got to walk up to the front and sit down in the chair where the nurse/technician drew my blood. I'm sure it was quite interesting to everyone sitting behind me with a clear view of everything that was being done.

I don't know a lot about the procedures for taking blood and what hygiene protocols are necessary but I suspect that not wearing latex gloves and cleaning the counter where dozens of patients' arms rest regularly are some of the things that would not pass an inspection by the WHO. I also had a moment of "OH MY GOD" when I saw a drop of blood on the counter below my arm while the tech was taking my blood . . . seriously, I really don't get how the facilities can be so modern and yet the methods . . . not.

As with every cultural perspective everything is relative. I'm sure people who live without the kind of medical care I've had my entire life would think I'm a complete idiot for even being bothered by something so trivial as a drop of blood, being watched by a group of people getting my blood drawn, etc.

I would respond by saying that EVERYBODY has something that triggers their sense of 'cultural vertigo,' their sense of this is not "normal" or this is not 'how things are supposed to be done' . . . and for me, medical stuff is one of those triggers . . .

Finishing the 2nd floor nightmare I was told to go up to the third floor for X-rays--but I didn't understand anything that was said to me in Korean other than 'go to the third floor' . . . so I went up to the next floor wondering what I would see next.

X-rays . . .

The X-ray technician was a nice guy who asked me if I spoke Korean IN KOREAN (the IRONY of asking this kills me every time, lol) and I said very little. He then proceeded to tell me in Korean that I needed to press my torso against the machine's screen, hold my arms behind my back, take a big deep breath, and hold it while he took the X-ray. I know that it's not realistic to expect Koreans to understand that the odds of an expat English native speaker knowing enough Korean language, and having a high enough level of listening ability to understand fluently and quickly spoken SPECIALIZED language for hospital X-ray situations to SLOW DOWN FOR THE FOREIGN GUY--but seriously, isn't that kind of intuitive?

Later on I had a conversation with my female coworker about the gendered differences in the medical check. I guess women are asked if they're single or in a relationship (meaning 'sexually active'). How being single means you are NOT having sex is highly amusing to me because of the number of assumptions that have to be made to reach that conclusion. I think if you say you're sexually active and/or you're in a relationship you then have to get a 'lower regions' exam done. I don't know if this applies across the board in all clinics and medical checks for foreign women in Korea but it's something to be aware of.

Women also may get a breast exam done, too. Guys, however, don't get the 'turn your head and cough' check, and they also are not asked to 'bend over' while the doctor puts on a rubber glove and . . . you fill in the rest.

It makes me grin like an idiot to think of how quickly a mass exodus of male foreign English teachers would take place if a prostate exam is added to the E2 Visa medical check--LOL!!!

Essentially, female foreign English teachers should be prepared to answer questions that would NEVER be asked back in our home countries, and possibly to do tests with a MALE doctor who may or may not speak English.

On the fourth floor I saw a wide range of diagnostic equipment set up along a wall out in the open . . . in the center of the room was a long line of chairs where people can sit and watch everything that is going on--meaning, watch the foreign guy get his medical check done.

Not sure what these things are as I didn't get tested with them . . .

I was told to stand on the two yellow feet painted on the floor. I then got my waist measured . . . the nurse didn't bother measuring my chest which I found amusing because they did the last time I had a medical check . . .

I then had my eyes tested. It was very weird. I had to look at the figure of an "E" on a computer screen while covering one of my eyes. It would change position (facing up, to either side, or down) and I had to point in the direction the figure was facing for the nurse.

I then stood on a digital scale and height measuring device--I was waiting for it to say my weight out loud with a volume high enough to carry down to the other floors of the building . . . but it didn't do that. I winced at my weight--yes, exercise and nutrition are something that need to be improved--and then got off the machine.

After being weighed and getting my height measured I got to get my blood pressure checked. I thought it was very funny to do the weight check BEFORE the blood pressure because I imagine that everybody, myself included, generally tends to feel anxious when being weighed in a room with several Koreans all watching you. Anxiety = stress = raised BPM and blood pressure . . . hmmmm, it's not really a good idea to make your patients feel anxious because of the test that is before the blood pressure station, is it?


I got the results of my medical check back a couple days ago. I realized that I had not asked if they test for HIV or drugs (mandatory parts of the medical check that you must have done to get an E2 Visa in Korea). I asked the university secretary to call the clinic's office to confirm those two items hadn't been done--yep, not done.

Because I was a part of the group of university professors getting their medical checks done HIV and drugs were not on the list of things to be checked. The interesting assumption here being if you're a Korean and a professor that drugs and HIV don't need to be tested for--but if you're a foreign professor they do need to be tested for . . . methinks something about the policy has a rather biased ethnic perspective . . . which is putting it politely in order to avoid using the big "R-word" about this whole topic . . .

So I went and got this medical check done when I didn't need to do one because everyone else was doing it--and while it was free, I'll still have to go and pay for another medical check because HIV and drugs weren't tested . . .

. . . or will I?

This is where things get really interesting . . . I decided to ask the university secretary to call the immigration office to see if I could get a form in Korean language to take with me for my 3rd (sigh) medical check of 2008. While she was talking to the immigration officer I asked her to also confirm that I need a medical check with HIV and drug test, and a criminal background check/VSS for Canadians done . . .

The officer told the secretary that I do NOT need a medical check or a criminal background check done IF I am renewing my contract and E2 Visa with the SAME EMPLOYER as of December 16th.

I . . . blinked . . . picked my jaw up off the floor . . . and asked the secretary to confirm what she had just said.

I still couldn't believe it. The secretary handed me the phone saying that the officer could speak English (wow) and I asked the officer when the E2 Visa policy had changed. She repeated everything again . . .

I still couldn't believe it. Every Canadian English teacher in Korea that I know is going through HELL right now trying to do the bureaucratic nightmare paperwork in order to get a VSS criminal background check . . . and I had just been told I don't have to do it?

I told the immigration officer that I was having a hard time believing the policy had been changed. I told her that I was very very worried that when I go to the immigration office in January to renew my E2 Visa that I was concerned a different immigration officer would tell me a different interpretation of the application process and policy.

I asked her if the policy was on the immigration website--no. She told me that the best way to find out the current criteria for the E2 Visa policy was to call the immigration office . . .

I'm going to check again this coming week if the policy is the same as what I was told over the phone. I wonder if the secretary gets a different immigration officer on the phone if the information will change . . .

I also wonder how it's possible for the E2 Visa policy to be implemented so differently across an entire country. I suspect that because my employer is a national university of education that I am getting the least strict interpretation of the policy. I bet that hogwan foreign English teacher applicants have to have their DNA tested (not really, but it sounds so much more melodramatic, doesn't it?) along with a billion other items, public school teachers slightly less, and so on and so forth 'up' the ladder in terms of how different types of teachers are ranked socially in Korea in terms of status.

I'll write more about the E2 Visa renewal policy for out here once I find out that things have changed and that I wasn't just getting ONE officer's idea of how the policy is supposed to be done, and on another day with a different officer hearing something else . . .



Brian said...

Wow, a lot to comment on here. As for visa requirements changing . . . yeah. Nobody has any idea about anything. As I wrote about before, I had to do a whirlwind tour of Seoul and Gwangju, spending over 100,000 won in motels, tickets, and fees to get both my CBC and my affidavit, only to go to Yeosu immigration and have them tell me I didn't need it. Thus contradicting months of information we had been getting.

My medical exam wasn't like the one you described. Well, I should be more clear. Neither of them this year were. I had two medical exams within a week of each other. One was for my E-2 renewal, one was for my public school contract. I wasn't able to have the results of one count for the other. Both times were okay---I mean, cultural vertigo as you said, but not as frustrating as I was expecting---and the second time everyone was super kind and super quick. I was in and out in about 15 minutes. Perhaps speed isn't the best thing to have at a medical exam, though.

I recall my first year getting the mandatory health check. Our school board asked for tests of all our vital organs. The doctor said it woudl be really expensive to do that, so he asked me "is your liver okay?" "is your stomach okay?" "are your kidneys okay?" and so forth.

The hypocracy about foreigners and HIV . . . don't get me started. I wonder if the business about leaving pee and blood out in the open, and not wearing gloves for anything stems from an outmoded interpretation of how diseases spread. I mean, this is a country where people don't cover their mouths to sneeze or cough, and one with the highest rates of new TB infections in the world.

You left out one bit of medical misadventure and malpractice. The way they take your x-rays without providing any lead protection and without the technicians standing behind any sort of barrier. Again, you have to wonder where people are getting their information. I myself haven't the first idea about practicing medicine or working in a hospital . . . but then again I don't practice medicine or work in a hospital.

Thanks for sharing. I might link to this next week because I've had tons of conversations like this in real life.

Anonymous said...

Yep, great post. Thanks for telling others about your experience.

As for Immigration's left hand not knowing what the right hand is doing: while I was in the US on vacation last summer, my supervisor called Immigration three times over the course of the summer and was assured each time that I wouldn't need to do anything extra to renew my visa. You know what happened when I went in to renew, right? Yeah, I was given 30 days to get everything done or be booted.

Please let us know what happens.

Dan said...

It's easy to conclude that the clinic you went to was not the most professional. I've never seen conditions like that any any of the exams that I've done, both at smaller hospitals/clinics and larger ones.

While the public tests are certainly common, most are public at American facilities as well, at least drawing blood, height, weight and blood pressure. The biggest difference is just that there is more care in making the results private.

That pee cup table is crazy. Were those Dixie cups? I've never seen those used before. I'm a complete germophobe and that would drive me nuts.

Additionally, that blood on the table thing...I would have freaked out.

My suggestion is to try to hit the bigger hospitals, if at all possible, for exams and advanced care. In Seoul I'd recommend, Seoul National University Hospitals (Yongon & Bundang), Samsung Hospital, and Yonsei Severence--the foreigner clinic is particularly good.


ROK Hound said...

Regarding this piece:
"Why is there a difference between beer/wine/whiskey and soju? Is drinking soju generally considered to be 'less harmful' because it's a Korean traditional drink?"

Actually, no. Soju is considerably MORE harmful than beer or wine, certainly. It's rot gut. Cheap ass rot gut. It's been linked to the stratospherically high incidence (comparatively) of stomach cancer in Koreans.

Jason said...

It's kind of funny that you said, "In Seoul I'd recommend, Seoul National University Hospital"

Have you seen the posting I did about when my girlfriend and I were in Seoul and she needed to go to a hospital? LOL . . . Check it out.

I'll acknowledge went there on a Friday night, on a national holiday, when it was INSANELY busy and they looked a little understaffed . . . but I still stand by what I wrote in that posting . . .

Happy New Year,

Jason said...


When I wrote that I wondered if soju is perceived to be in a different category of alcoholic drink when compared with beer, wine, and whiskey it was in the sense of wondering if there is a cultural myth that because soju is a traditional Korean drink that it is somehow more 'healthy' than foreign alcoholic drinks, or something in the vein of thought in Korean culture . . .

I don't think there is that kind of a well being myth about soju but I was trying to figure out why the questionnaire was organized that way.

The stomach cancer thing is brutal, and I don't think I've seen any ads on TV or public awareness posters about the health risks associated with soju . . . then again, my Korean language skills are abysmal . . . have you seen anything on TV, the Net, or out on the street in Korea?

Happy New Year,

Topher said...

That's hilarious -- my experience was almost identical. Except I left my pee cup in the bathroom --as I would in the states -- and the nurse was horrified. I'll never understand why.

I really like your term "cultural vertigo" -- I've experienced that exact sensation -- a weird tilting of the earth under my feet -- and haven't known what to call it. This is when I feel like I've stepped into a fun house.

Jason said...

Hi Topher,

I just did a google search for "cultural vertigo" and realized that while I've never read the term online before, and I don't think I've ever come across it in the cultural studies articles and essays I've read, the pscyh courses I took in university, or anywhere else . . . apparently I'm not the first to use the term 'cultural vertigo' though I MIGHT be the first to have used in the context and experience of expat life in Korea . . . donno about that either.

Some bloggers seem to be really aware of, and concerned about, who said what where when why and how FIRST . . . I don't really pay much attention to that other to make sure I'm not posting something that's already been posted in the same way with the same things being written cause then it just gets ridiculous . ..

Anyways, I'd better add an update to this post before someone accuses me of lifting the term off of someone else's site, blog, or whatever . . .

All this being said, I think the term 'cultural vertigo' does capture the expat/foreign teacher in Korea experience better than 'culture shock.'

Happy New Year,

Anonymous said...

Hey Jason,

The reason why they ask specifically how much soju you drink is b/c Koreans measure alcohol quantities and tolerance in bottles of soju, as soju's alcohol content is relatively standardized and b/c soju is, as you know, the drink of choice of most Koreans (for whatever reason). This question is asked in ordinary conversation as well as in job applications, and I've seen it in both contexts personally. I also understand, through personal experience, the frustration you've experienced in Korea as a foreigner, the xenophobia, ethnocentrism, etc., but not everything Koreans do is that completely inane. Hang in there man.

Jason said...

"but not everything Koreans do is that completely inane"

If I'm going to be given a health check it's going to be based on sound medicine and science--not a set of culturally defined norms that pass as 'medicine' and 'science' . . .

I GET that the questions about drinking use the socio-cultural frame of reference based on the average education levels of the average Korean, and also based on the drinking cultural norms here . . . I think what irks me about this is the notion that my health is actually being 'checked' in a way that has any kind of meaningful connection to my status as a teacher of children in this country, etc.

As many other expats have said, I'm fine with having to do the health check as long as ALL other teachers, regardless of race or citizenship, have to do so too. Otherwise it's race-based discrimination that has nothing to do with health and is simply about maintaining the status quo and keeping the average misinformed person in Korea happy that the foreigners are 'under control' . . .


Anonymous said...

What have you heard about them testing for alcoholism? I like to drink, but I wouldn't call myself an alcoholic. Do they just ask you questions, or do they test your blood?

Anonymous said...

Yeah, I didn't read all the way through, but that was pretty much my experience as well. They just had a tray where we all put our full pee cups. No lids. No validation that we were actually the one that peed in the cup.

Barca said...

I just went through something similar with my medical check. I went to a prominent Busan hospital and was shuttled around like livestock being prepped for market. There was not any protection during the x-rays, one of the prcedures I have a big problem with. I got attentive but nervous service, in general. I was stuck badly with needles twice and look like a heroin junkie's dream girl today - two nurses cooed worredly over me as they worked the needles in and out of my arm. Incompetent, or do I make them nervous? Alos, I had to deal with the pee in a cup issue, trotting my filled (transparent) cup out for all the curious onlookers to witness ("Does the foreigner... pee?"). In general I resent this treatment and having to take a yearly AIDS test. I understand drug testing, fingerprinting for teachers, but the rest is crap. The forms we fill out are culturally biased and silly. Not only are the regulations discriminatory, they are haphazardly enforced.

Anonymous said...

SO...ahem... Do the males get any "lower region" inspection? Not to be crude but if some Korean Doctor is going to feel me up, I'd like an advanced notice. Also, they don't hover over you when you pee, right?