‘Junior surgeons’ training period should be extended back to 4 years’

The Korean Surgical Society (KSS) is struggling with the curriculum to train competent surgeons.

Some KSS members have maintained that the three-year training program for surgical residents should be extended to four years. They pointed out that the three-year training program is not enough to ensure the quality of training, as the training time has been shortened in the past due to the Medical Resident Act.

"Three years under the current Medical Resident Act are not enough to foster good surgeons," said Yu Hee-chul, vice president of KSS, at the 2024 Grand Debate with the theme of “Dying Surgery Department as the Center of Essential Care Requires Urgent Resuscitation,” last Saturday.

Yu noted that in the past, the KSS changed the training process to one year of internship and three years of residency to end the training quickly and provide advanced training through the fellowship program.

"However, with the change in the Medical Resident Act and the shortened training time for trainee surgeons, we cannot provide sufficient education in three years, so we need a step-by-step, mid- to long-term perspective to move to a four-year program and even a five-year program," said Yu, also the head of KSS’ Training Environment Evaluation Committee. “Three years are insufficient to train a good surgeon under the current residency law."

He added that the KSS must make efforts to improve the quality of the training program and the medical environment so that surgeons can be recognized and practice as specialists.

"I don't think it's necessary to go through the process of trainee surgeons if the medical environment is not sustainable for them (in the field)," Yu said. "A big part of the reason for the decline in the application rate of surgical majors is low medical fees and the undervalued environment compared to the high-intensity work after becoming a specialist."

Yu continued, "The roles that surgical specialists can play and the medical environment must be improved. In the big picture, there must be an environment where surgeons can be in charge of surgery at general hospital-level medical institutions rather than general practitioners and demonstrate their abilities."

In addition to the need to evaluate the three-year policy for surgical residents, some expressed views that the goal of training surgeons should also be reviewed.

"The prerequisite for reducing the training program for trainee surgeons to three years was the recruitment of hospitalization specialists," said Yoon Yoo-seok, professor of surgery at Seoul National University Bundang Hospital. "However, we cannot recruit hospitalization specialists if we try. We must consider whether the KSS policy (of reducing the program to three years) is a failure or whether we should discuss switching to a four-year program."

Professor Yoon continued, "The program's goals should change according to the working hours of trainee doctors. We need to change the goals of the surgeons we train. I hope we can create a system that can train surgeons properly."