Despite a thaw in conflict, essential departments worry about lack of trainee doctors

The dialogue between the new government and the medical community has raised hopes for the return of medical students and trainee doctors.

However, the so-called essential medical departments can ill afford to share such expectations. Even if the government-doctor conflict is resolved, it is still difficult to expect trainee doctors who have left their training sites to return

In a survey of resigned junior doctors nationwide conducted by the Korea Intern Resident Association (KIRA)’s emergency committee on Monday, some respondents said they had no intention of resuming practice.

While the committee did not disclose the numbers, it noted that 76.4 percent of the participants cited a review of the previous Yoon Suk Yeol government's medical policy as a precondition for resuming practice, explaining that "about a quarter of them would not consider resuming practice under any conditions.” The survey involved 8,458 participants.

Notably, 72.1 percent of the resigned junior doctors who said they had no intention of resuming training were from the eight government-designated essential specialties: internal medicine, surgery, obstetrics and gynecology, pediatrics and adolescence, neurology, neurosurgery, emergency medicine, and cardiovascular and thoracic surgery. This is a “numerical confirmation” of the training hospitals’ prediction that doctors majoring in these specialties “will not return to hospitals.”

Unless they are senior medical residents who are about to take their licensing exams, they “see no reason to stay in the hospital and retrain and become licensed specialists,” the committee pointed out.

In a recent roundtable discussion on the 33rd anniversary of the Korea Doctors Weekly, the sister paper of Korea Biomedical Review, executives in charge of training from the Korean Association of Internal Medicine, the Korean Surgical Society, the Korean Society of Obstetrics and Gynecology, and the Korean Pediatric Society said it is difficult to expect all residents who leave their training hospitals to return.

“Only 50-70 percent will return,” said Dr. Choi Dong-ho, director of training at the Korean Surgical Society. Dr. Hong Soon-cheol, head of the Training System Development Task Force at the Korean Society of Obstetrics and Gynecology, said, “Medical residents in their first or second year will not return.”

Other departments’ situations are similar.

“Internal medicine is moving toward an atmosphere where few doctors are willing to return to training,” said Choi Chang-min, a professor of respiratory medicine at Asan Medical Center, who chaired the second term of the National Committee for Emergency Preparedness of Medical Schools, at a seminar organized by the Medical Ethics Research Association on Monday, the same day the KIRA survey was released.

Professor Lee Kyung-won of Yongin Severance Hospital, the public relations director of the Korean Society of Emergency Medicine, also told the media on the same day, "As of July, there were more than 80 doctors in training in emergency medicine. Most of the first- and second-year residents who resigned are not expected to return,” he said, predicting that a shortage of emergency medical personnel will occur nationwide in the future.

Professors agree that the government must make a “bold resolve” to encourage residents to return to practice, stressing that it shouldn't be seen as a privilege.

They emphasized that legal improvements, such as immunity from criminal penalties and limits on civil damages, should be made, as well as bold support for emergency medicine. There should be tangible measures to encourage doctors to choose emergency medicine as a specialty in exchange for fair compensation, the professors added, such as increasing the number of emergency physicians.

"Public opinion says that the government should not give trainee doctors preferential treatment.’ If things continue like this, however, the so-called essential departments are bound to perish. If there are no trainee doctors and no specialists are produced, there will be no fellows, either. Eventually, there will be no professors to handle serious diseases in university hospitals," Professor Choi said.

Cheong Jeong-il, a spokesperson for KIRA’s emergency committee, also said, "The government and the medical community should discuss how to allow these ‘essential’ department trainee doctors to resume training and regain their will to become specialists."

"We will do our best to restore trust with the government and have forward-looking discussions so that the number of responses from resigned trainee doctors who say ‘I will not give up and resume practicing’ increases," Cheong said.