[Edaily Reporter An Chi-yeong ] A professor at the Neonatal Intensive Care Unit (NICU) at Chonbuk National University Hospital, who had been working over 90 hours a week to staff the ward, recently submitted his resignation after reaching his limit. However, concerned for the babies still in the NICU, he ultimately returned to his post. Chonnam National University Hospital is also only accepting about half of the transfer requests for high-risk newborns due to a shortage of medical staff. As the capacity of regional hub hospitals declines, there have been repeated instances of newborns being transported long distances to find beds where they can receive treatment.
According to the medical community on the 9th, as the workforce for critical and essential care ages and the number of doctors continues to decline, it has become a reality that newborns less than a day old must be transported hundreds of kilometers to receive intensive care. This is because while professors in essential medical fields—who have treated critically ill patients and trained the next generation—are aging, the young doctors who would take their place are disappearing.
In some essential medical departments at regional university hospitals, elderly professors are effectively holding the fort alone. Amid persistent low reimbursement rates and the burden of medical malpractice claims, the number of staff available to share the workload of surgeries, on-call shifts, and emergency calls is dwindling, causing the workload of the remaining professors to grow increasingly heavy.
A decline in the next generation of specialists is expected not only in neonatal intensive care but across the entire spectrum of highly specialized pediatric essential medical fields, such as pediatric cardiology and pediatric surgery. The Korean Society of Pediatric Cardiology projects that if current trends continue, the number of pediatric cardiac surgeons will drop from 33 in 2023 to 17 in 2035. The number of pediatric cardiologists is also projected to decrease from 129 to 94 during the same period. The Korean Society of Pediatric Surgery also predicted that the number of active pediatric surgeons will decline by more than 20% by 2030.
Medical students and residents are turning away from essential medical fields after witnessing the high workload and poor working conditions faced by their professors. Some residents in essential medical fields and young specialists even self-deprecatingly refer to their situation as being “instant losers.” Although they chose a path dedicated to saving lives, their peers are opening private practices or opting for non-essential medical fields. This means they are the only ones left to bear the burden of poor working conditions, the risk of medical malpractice, and repetitive on-call duties.
The medical community fears that this goes beyond simply a few doctors retiring; it could lead to a break in the surgical techniques and experience in treating critically ill patients that have been accumulated over decades. Ultimately, the burden will fall on patients who are unable to receive treatment at the most critical moments.
On the ground, experts point out that to resolve this issue, efforts must be made to address workforce training, working conditions, and patient transfer systems simultaneously.
In the short term, a system is needed to establish regional neonatal transfer coordination centers and dedicated transport teams, as well as to provide substitute staff to hospitals facing staffing shortages. Along with this, compensation for night and holiday on-call shifts, 24-hour standby duty, and high-complexity care must be strengthened, and appropriate staffing standards and a medical dispute support system must be put in place.
In the long term, support should be provided by linking residency, fellowship, and professorial positions at regional hub hospitals, while establishing a rotation system with local hospitals and a collaborative care network to ensure that patient access is not compromised.
Kim Yoon-ha, a professor in the Department of Obstetrics and Gynecology at Chonnam National University Hospital, emphasized, “We must be able to restore the workforce pipeline that progresses from residents to attending physicians to full-time faculty,” adding, “We need to establish a system that enables the continuous training of essential medical personnel centered around regional hub hospitals.”
