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A friend of mine who is a pediatrician plans to quit her job at a local university hospital. She says she intends to prepare for the U.S. medical licensing examination and move to America. She will have to do her residency again, giving up all of her accomplishments as a clinical professor here. Nevertheless, she says she will have no regrets.
She is one of many young pediatricians quitting their jobs at Korea's university hospitals. In fact, not only they are leaving; interns are no longer applying for pediatric residencies in the first place.
There were a total of 207 residency jobs open for aspiring pediatricians this year, but only 33 people applied. Among the 60 hospitals that tried to recruit pediatric residents, 49 received no applications at all. The shortage of residents has lasted for a few years, and now professors are being forced to fill in the vacancies, taking turns to cover night shifts in wards, ERs and neonatal intensive care units. They are having to treat patients, write research papers for journals, teach medical students and train residents ― all after having just a few hours of sleep following night shift.
Behind the decline of the field of pediatrics is ― of course ― Korea's low birthrate. Medical students exclude pediatrics from their choices of majors as they fear that they will end up closing down their clinics due to the steep fall in the number of young patients. COVID-19 turned that fear into a reality. As children stayed at home, their visits to clinics also dropped. According to Ministry of Health and Welfare data submitted to Rep. Song Seog-jun of the ruling People Power Party, 662 pediatric clinics closed down between 2017 and August of this year. During the same period, 275 obstetrics clinics closed down. A number of counties in rural provinces have no pediatricians at all. Many of the pediatricians who closed down their clinics got jobs as medical staff at nursing homes for senior citizens, or switched to working at skincare clinics.
Korea's low birthrate and shortage of pediatricians are negatively affecting each other in a vicious cycle. The lack of proper medical services makes people wonder, "Is it even okay to have babies?" Only 36 percent of university hospitals around the country offer emergency care by pediatricians. If a baby suddenly suffers from a fever, parents will have to wander around looking for ERs with available pediatricians. And ERs are not the only facilities being affected. Gachon University Gil Medical Center in Incheon recently made headlines by announcing that it won't offer hospitalization services for pediatric patients. The hospital says it will resume the services if someone applies for the pediatric residency in March.
Being a pediatrician is a stressful job in itself. Unlike other doctors, pediatricians must handle little patients who can't articulate what their problems are. Their parents are often demanding, especially in this era when most Korean families have only one child. Pediatricians choose their job for diverse reasons, but many of them say they chose it out of their love of children. My aforementioned friend chose it because she herself got significant help from pediatricians while she was growing up. I bet no pediatrician chose his or her specialization for money as he or she probably had other options of going into better-paying fields. Pediatricians have been at the bottom among doctors in terms of annual income. But now they seem to have reached a point where they simply can't do it anymore.
Korea's low number of births means less demand for pediatricians, but the profession shouldn't be determined only by supply and demand, since the government has also distorted the market. The country's major children's hospitals suffer from chronic deficits as the government's healthcare insurance gives them less than the costs incurred. Their deficits only grow if these hospitals treat more patients. University hospitals have been making up for this loss from the money they earn elsewhere, such as via expensive luxury health check-up programs.
Everyone says that Korea's abysmal birthrate is a serious problem that threatens the future of the country. The number of babies born per woman stood at a mere 0.79 in the third quarter of 2022, which is the lowest in the world. Korea's economy is expected to start to contract from the 2060s as the population continually shrinks.
The government plans to give 700,000 won ($540) a month to parents of babies who are less than one year old from next year. The incentive will be raised to 1 million won from 2024 in an attempt to pull up the birthrate. However, the baby isn't guaranteed proper medical care. Would you want to give birth to a baby under these conditions?
The writer (yjy@koreatimes.co.kr) is the finance editor of The Korea Times.
