[Inside Chodong] Hospitals Without Residents

Despite the government presenting various incentives, medical students and residents have no intention of returning. As of the application deadline on the 26th for next year's national medical licensing exam (clinical skills test), only 11.4% of the total eligible candidates applied. When considering only medical students, excluding last year's failures and foreign medical graduates, only 5% applied. Although about 3,000 new doctors have been produced annually, this supply will effectively cease next year.

Training hospitals are currently recruiting residents for the second half of September (fall turn), but it is highly likely that most resigning residents will not apply, so the shortage of medical personnel is expected to continue. A senior official from the Ministry of Health and Welfare stated, "Medical associations may come up with new demands early next year, but from the government's perspective, there will be no further (special) opportunities after this second half recruitment." If this continues, interns and residents training at large hospitals will disappear one after another.

Is that why? The government is already preparing the next step: a structural transformation to allow tertiary hospitals to operate without residents. The plan is to shift tertiary hospitals, which have grown excessively dependent on resident manpower, to be specialist-centered and focus solely on severe and emergency care. The government plans to release the final plan for this structural transformation around the end of August and start a pilot project from September.

The government intends to respond primarily through collaboration between experienced specialists and physician assistant (PA) nurses in terms of workforce structure. Until now, hospitals have operated mainly on the "young and cheap labor" of residents in training, but going forward, a significant portion of that role will be assigned to PA nurses. To do this, institutionalizing PA nurses through the enactment of the Nursing Act is a priority, but sufficient discussions among various health and medical professions have not yet taken place.

The working conditions of residents will also be improved. Resident working hours will be reduced from 80 hours per week to 60 hours, and the maximum continuous working hours without rest will be cut from 36 hours to 24 hours. The number of supervising specialists will be increased, and the state will strengthen its responsibility by supporting training costs. However, given the shortage of specialists and the reality of having to rely on PA nurses, there is no concrete plan on where and by whom these residents will be trained.

During the structural transformation of tertiary hospitals, a change in the perception of medical consumers?the public?is also necessary. The government has planned to strengthen essential medical fields such as emergency, cardiovascular and cerebrovascular, trauma, and high-risk childbirth in tertiary hospitals, while reducing general hospital beds by up to 15%. Patients with moderate or less severe conditions will be referred to cooperative hospitals, and mild cases will be handled at clinic-level facilities, strengthening the cooperative care system. This means that patients' demands to be transferred unconditionally to large hospitals or hospitals located in Seoul will no longer be accepted.

Medical reform, including increasing medical school admissions, has become an irreversible national demand. The direction that tertiary hospitals should shift from resident-centered to specialist-centered is also a broad consensus shared by both the government and the medical community. However, all these plans are possible only under the premise that there is sufficient physician manpower and that patient care and hospital operations are functioning normally. In the current situation where residents who will become future specialists are leaving hospitals and professors are refusing to train new residents, it is premature. While medical reform should proceed without setbacks, the priority is to devise a strategy to bring doctors back to the clinical field.

This content was produced with the assistance of AI translation services.