조선시대 내의원은 전의감에서 분설된 기관이었으나 국왕과 왕실의 의약을 전담하는 기관으로서 내의원에서 근무하는 의원은 전의감보다 그 위상이 높았다. 이는 태종대에 내의원에서 잘못을 저지른 의원이 전의감으로 내쳐졌던 일이나, 내의원 의원 출신으로 임금의 신임을 받아 포상을 받거나 외관을 제수받은 이의 숫자가 다른 잡직에 비해 월등이 많았던 사실 등에서 확인할 수 있다. 내의원 의관은 비록 잡과를 통해 출사한 기술관이었으나 그 업무가 국왕을 비롯한 왕실 일원의 생명과 관계된 일이었으므로 이들이 본업에 정진하지 않아 의술이 폐하게 되면 종사의 안위가 위태롭지 않을 수 없었다. 따라서 조정에서는 이들에 대한 처우에 고심하지 않을 수 없었는데, 그 본업인 의업에 충실하게 하되 이것이 지나쳐 의관이 되기를 기피하도록 하여서도 안 되었고, 반대로 의관에 대한 임금의 신임이 지나쳐 이들이 정사에 영향을 미칠 정도가 되는 것도 경계하였던 것이다. 그러나 이러한 양반사족들의 견제에도 불구하고 내의원 의원들은 최고의 의술을 보유한 전문가 집단으로서 조선 사회에서 널리 인정받았으며 사행길에 동행하여 약재를 거래하고 지방에서 진상할 약재의 종류와 수량을 결정하는 일에 관여하면서 부를 축적하였다. 특히, 19세기에는 자신들의 전문지식을 활용한 개인 약방을 개설하여 상당한 정도의 경제력을 보유한 독자적인 계층으로 성장하였으며 이러한 경제력은 중인 계층의 신분 상승에도 영향을 끼쳤다. 내의원에서 수행하였던 다양한 기능과 조선 정부가 취했던 내의원 의관들에 대한 처우에 대해 살펴보는 일은 조선 사회의 기술관에 대한 인식과 이들이 차지하고 있었던 위치를 파악하는 데 유용하다. 내의원 운영의 실제 모습을 구체적인 사례를 통하여 살펴봄으로써 조선 정부의 관제 운영의 일 단면을 더욱 심도있게 이해할 수 있게 되기를 기대한다.

Joseon was a country that used Confucianism as its ruling principle, and Joseon y was a society that was controlled by the Confucian values. Because of the rigid social order and the Joseon Dynasty's governing principle, it is possible that technical officials' social status was treated very poorly compared to the civil servant called 'Mungwan(文官)'. However, it is not correct to say that the Joseon government treated all the technical officials as inferior regardless of what they did. because royal physician were not that being poorly treated, for their important roles. The Royal medical institution called ‘Naeuiwon(內醫院)’ was a governmental institution responsible for prescribing and dispensing medicines used in royal palaces during the Joseon Dynasty. The term " Naeuiwon " was given the title because Because it was considered to be an institution that played a very important role in the reign of King Sejong (1443). The Royal medical institution was composed of doctors who had the best medical knowledge. Doctors in this institution, therefore, were not only responsible for treating the king and his family's illness, but also responsible for creating medicine for the king and his subjects each year, Publication of medical books, Management of Medicines in the Palace, etc. The economic reward of doctors in The Royal medical institution was relatively high, compared to other technical officials. There were a number of people who received high ranking positions called ‘Dangsanggwan(堂上官)’ from The Royal medical institution. The reason was that Royal physician had a chance to win the prize because they had a chance to treat the king, and there were many members of the aristocracy called ‘Yangban(兩班)’. Doctors in the Royal medical institution were related to the royal family's life, so if their skills were deteriorating, the royal health could not be compromised. Therefore, the Joseon Government could not afford to deal with them. Members of the Royal medical institution had never decreased by one in KingYeongjo's reign, except for reducing the number of lower of Seven-level official(從7品) from three to one. Doctors at the Royal medical institution were regularly given a salary called ‘Nokbong(祿俸)’ to pay for their classes. It was unusual for an government office that consisted of technical officials and engineers, to pay regular payments to most incumbent workers without using Che-A-Jik(A government post that pays only about two to six months a year). It is true that civil servants were fiercely opposed when the king tried to trust doctors to move to higher ranking positions such as dangsanggwan(堂上官) . But it was not because doctors were vulgar or low-rated in their jobs, but because doctors were excessively favored by king, civil servants were necessary to try checking their involvement in politics. Therefore, it would be more cautious to assume that the doctors were less recognized during the Joseon Dynasty or that the government treated doctors poorly during the Joseon Dynasty. However, despite the checks of these bureaucrat, the doctor was widely recognized in Joseon as a group of experts with the greatest medical knowledge of the nation. They accompanied the envoys to China and brought together the materials to be used to prepare medicines and sold them domestically. They accumulated wealth while determining the type and quantity of materials that make up the local tax. In the 19th century, they opened their own hospitals and grew up into an independent class with high levels of economic power. This trend also affected the rise of the whole middle class. The article describes the role of the Royal medical institution, and the operation of the organization, To rethink their social status during the Joseon Dynasty. Through this article, one will be more clear about the perception and the social status of the Royal medical institution and royal physician in the Joseon Dynasty.

The Royal medical institution(內醫院), royal physician(醫官), technical officials(技術官) civil servant(文官), government official‘s salary(祿俸), Che-A-Jik(遞兒職), High-ranking officials(堂上官), the status of royal physician