Regional healthcare is visibly collapsing as resigned trainee doctors refuse to return.

The government’s healthcare reform, which was supposed to revitalize regional and essential medical care, is destroying them. After yearlong burnouts following the government's push to increase the medical school enrollment quota, professors' sense of mission has vanished as hopes that their students will return were crushed.

“Resignation” has become the talk of the town whenever professors meet.

“The number of professors resigning is increasing. Of 150 professors, 30, or 20 percent, have already left,” said a professor of orthopedic surgery at a university hospital in North Jeolla Province. “More will leave as they have found new workplaces, and others are looking for new jobs. Unless junior doctors return, more professors will quit in February and March.”

However, the vacancies left by the departing professors cannot be filled. Provincial university hospitals are already facing severe workforce shortages and are desperate.

“No matter how many job postings we put up, no one wants to come. It doesn't matter how much we raise the salary,” the professor said. “After a year of being on call twice weekly for weekends and holidays, we are all in despair. Nowadays, professors talk about resigning whenever they see each other. It's like we're headed for the worst.”

The faculty exodus has led to a vicious cycle of declining quality of care.

The shortage of anesthesiologists and lack of dedicated inpatient staff has resulted in surgeries being pushed back, with waiting lists for cancer surgery in provincial areas of three to four months. Patients waiting for treatment at provincial university hospitals are turning to the so-called Big Five hospitals in Seoul.

“The provincial healthcare system is on the verge of collapse. The lack of anesthesiology professors makes it difficult to perform surgeries smoothly. The situation may be similar in Seoul’s Big Five hospitals. However, it is far more serious in provincial areas,” said a professor of radiology at a university hospital in Busan. “Stomach cancer surgery is pushed back by three to four months. Patients who don't want to wait for surgery for more than half a year go to the Big Five.”

“In the past, we conducted surgery to reduce the tumor area first and used hen chemotherapy. If the tumor is ambiguous, chemotherapy is used first, and surgery is done afterward due to difficulty in performing surgery,” the professor said. “Everyone is hush-hush. However, due to the manpower shortage, we do not accept inpatients after 10 p.m. unless it is an emergency if there is an outpatient the next day.”

Many doctors are also concerned that the government's pilot project to restructure tertiary general hospitals could further shake up the regional healthcare delivery system.

They warned that the accelerated exodus of professors from provincial university hospitals could lead to the collapse of the medical system. Some criticized the restructuring project as a “meaningless policy” in the current situation where it is impossible to produce specialists.

“Professors who have moved from university hospitals to small- and medium-sized hospitals say that even if they want to work hard, they often have to transfer patients back to university hospitals without being able to handle complex diseases, making it difficult for them to demonstrate their capabilities,” the professor in a Busan university hospital said.

This means that even if experienced professors at large provincial hospitals move to smaller institutions, the professor added that they have limitations in an environment different from university hospitals.

“We have been holding on with a sense of mission to take responsibility for regional healthcare, but medical students and junior doctors are leaving for Seoul,” he said. ”University hospitals are also lowering their standards so that they can see patients by reducing research and teaching. The capabilities of professors at university hospitals are bound to decline. This will adversely affect the medical delivery system.”

A cardiothoracic professor at one of the five largest hospitals said, “The government says that it will increase recruitment of specialists to transform the structure of tertiary general hospitals. However, since there are no trainee doctors, the only way to produce specialists is to bring professors from other hospitals. Professors at even university hospitals in Seoul are leaving. So, who will join this chaotic and disorderly scene?”

“Many professors quit provincial hospitals and moved to hospitals in the Seoul metro region. The government has only widened the medical divide between the greater Seoul area and the rest of the country. Cancer surgery patients are flocking to the Big Five hospitals from the provinces,” the professor said. “The government has broken the healthcare system that was working in one way or another. It is impossible to repair it as things stand now.”