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Surgery-related departments unpopular among medical students
By Lee Hyo-jin
Korea is considered an advanced country when it comes to the provision of healthcare services, as essential medical services are offered at relatively affordable prices thanks to the nation's solid state-run medical insurance system.
However, the recent death of a nurse working at one of the biggest hospitals in the country has revealed a serious vacuum in the medical system due to a dearth of surgeons.
A 37-year-old nurse working at Asan Medical Center in Seoul fell unconscious after showing symptoms of a brain hemorrhage, July 24. She received emergency treatment for the embolization but there was no neurosurgeon at the hospital who could perform a craniotomy, a type of surgery where a bone flap is temporarily removed from the skull so as to gain access to the brain.
The patient was transferred to Seoul National University Hospital, located some 10 kilometers away, where she was pronounced dead after having missed the golden hour for the life-saving procedure.
Officials at Asan Medical Center later explained that the hospital is staffed with two doctors who are capable of performing the surgery, but both were off duty at that time.
A severe shortage of surgeons such as general surgeons, neurosurgeons and obstetricians is fast becoming the reality in Korea.
The surgery department has now become one of the least popular specialties among medical students, due to poor working conditions and significantly lower salaries compared to the heavy workload required.
According to health ministry data, in 2022, only 137 trainees applied to the general surgery departments at 55 hospitals across the country, leaving nearly 50 slots empty among the total 180. The cardio-thoracic department filled only 23 out of 48 places. The pediatrics department was able to fill only 57 out of 203 total slots.
On the other hand, the competition for dermatology, plastic surgery and ophthalmology departments was high, filling all or 99 percent of the available places in those fields. These departments are the most profitable areas considering that trainees later run private practices, due to the high demand.
Lee Woo-yong, head of the Korean Surgical Society, said the recent death of the nurse at Asan Medical Center is “only the tip of the iceberg.”
“If you look at rural regions, there are merely one or two doctors per province who are qualified to perform cerebrovascular surgeries. And many patients can't afford to travel to major hospitals in the capital and thus fail to receive due medical attention,” said the surgeon at Samsung Medical Center. “But things will get much worse in the future when the demand for major surgeries is expected to increase due to the rapidly aging population.”
Lee counted several reasons why medical students are turning away from a career in surgery such as low compensation compared to the heavy workload, along with the high risk of getting involved in medical disputes.
In the past, students opted to become surgeons to feel a sense of accomplishment and do something meaningful for others. “But those days are gone,” Lee said.
“Nowadays, young people in their 20s and 30s place bigger value on their own time and family over work. They don't want to choose a harder path unless it guarantees them subsequent compensation.”
Under the current medical system, dermatologists and plastic surgeons get bigger payments for conducting cosmetic procedures than surgeons who perform high-risk surgeries.
The Korean Intern Resident Association (KIRA), which represents over 16,000 trainee doctors across the country, observed that medical students are “being forced” to avoid surgical departments due to unreasonably low compensation compared with the harsh working conditions.
“Even if a student wants to choose surgical, pediatrics or obstetrics departments, he or she would give up after seeing the harsh path that lies ahead,” Yeo Han-sol, head of KIRA and resident doctor of emergency medicine at Ewha Womans Hospital Mokdong Hospital, said during a press conference earlier this month.
| Vice Health Minister Lee Ki-il speaks during opening ceremony of a task force aimed at expanding essential medical services, held at Government Complex Sejong, Thursday. Yonhap |
Against this backdrop, the Ministry of Health and Welfare launched a task force, Thursday, to expand the number of personnel and improve the quality of essential medical services.
The ministry will map out a plan to increase compensation to doctors performing high-risk and difficult surgeries such as cerebral aneurysm craniotomy and cardiac surgeries by increasing subsidies to private hospitals. The health authorities will also come up with compensation plans for children's hospitals, which are suffering from financial losses due to plunging demand.