As hospitals shortened internal medicine residency training from four to three years, physicians are expecting a shortage of patient care. However, hospitals have failed to prepare adequately for the shortfall and need to work out measures urgently to tackle the problem, doctors said.
Some have proposed hiring more hospitalists. It is not certain, however, such hiring can solve the problem because not many trainee doctors apply for hospitalist positions, except for those working at large-sized hospitals.
Most hospitals will try to make professor doctors do the shifts until they can hire hospitalists but it will be a mere stopgap measure, many physicians said.
One fellow at a teaching hospital’s internal medicine department in Busan said as the hospital did not notify of shift duty when recruiting fellows, professors instead of fellows decided to do the shifts. “Because we’re understaffed, we and professors aged under 60 decided to do the shifts,” he said.
A university hospital professor in the Seoul metropolitan area said the hospital would hire more hospitalists and nurses to prevent the treatment vacuum. “However, it is difficult to recruit hospitalists. We lost almost one-fourth of the workforce in our department, but there is nothing we can do,” the professor added.
Another teaching hospital in the capital area is also facing difficulty in recruiting hospitalists. A professor at the university hospital said, “It is natural to experience patient care shortage because the residency period was shortened from four to three years. Our hospital plans to use more hospitalists. As the government policy aims to encourage tertiary hospitals to focus on severe cases, we decided to reduce care for patients with mild symptoms.”
The professor said he felt sorry that residents rarely apply for hospitalists.
“After residents take the test to become specialists, the hospital will have some adjustments. Until then, we are trying to utilize our human resources as much as possible,” he added.
Another professor said hospitals should reduce the number of hospitalized patients until the hospitalist system takes root.
The professor working at one of the five largest hospitals in Korea said, “Even with a reduced number of residents, large hospitals will not have a big problem because they have many positions for residents and fellows.”
However, professors at hospitals in provincial areas will have to share the work with residents because fellows or hospitalists avoid working there, the professor said.
“However, we can’t say professors should share the burden all the time. If they can’t take it anymore, we don’t have any other option but to reduce the number of inpatients. Otherwise, we will have a problem in patient safety,” the professor added.
Yet another professor at a different university hospital said the Ministry of Health and Welfare should increase the number of resident positions as requested by the Korean Association of Internal Medicine.
“Increasing positions of residents for big hospitals is not meaningful. The positions should be expanded for those good at training and facing a shortage of residents,” the professor said.
The professor suggested the government should improve the medical delivery system to reduce patient visits to large hospitals and encourage patients with mild symptoms to visit a clinic or a smaller hospital in the neighborhood.
“A couple of measures cannot solve this problem. We need to improve the entire medical delivery system,” the professor emphasized.
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