"Emergency Room Collapse Already Underway"... Next Year, Emergency Medicine Residents Severely Insufficient

Strengthening Legal Liability for Medical Professionals, Deepening Aversion
"High Risk of Negligence Due to Frequent Emergencies, Support Likely to Decrease Further"

The resident (specialist trainee) recruitment rate for the Department of Emergency Medicine in the first half of next year has fallen to one of the lowest ranks among all recruitment fields. With the application rate plummeting every year, it ranked third from the bottom, following the already overwhelmingly avoided fields of Pediatrics and Obstetrics and Gynecology. The medical community analyzes this as a result of court rulings holding medical staff legally responsible for unavoidable emergency medical accidents.

The Ministry of Health and Welfare announced on the 27th that, as a result of recruiting first-year residents nationwide at 144 university hospitals for the first half of 2024, 2,792 were selected. In the Department of Emergency Medicine, 148 out of 193 recruitment quotas were filled, resulting in a recruitment rate of only 76.7%. Specifically, in the metropolitan area, 88 out of 112 (78.5%) were selected, and in non-metropolitan areas, 60 out of 81 (74%) were selected. Only Pediatrics (26.2%) and Obstetrics and Gynecology (63.4%) had lower recruitment rates than Emergency Medicine.

The fact that the number of residents selected in Emergency Medicine was less than the recruitment quota was already a foregone conclusion. This is because the number of applicants itself is low. In this recruitment, only 152 applied for Emergency Medicine. The application rate for Emergency Medicine residents has been steadily declining. The application rate was 86% in 2022, 85.2% in 2023, and sharply dropped to 79% in 2024, based on the first half of the year.

The avoidance phenomenon is intensifying as court rulings continue to impose criminal penalties on emergency medical staff for accidents occurring during the time-sensitive treatment process. On the 14th, the Supreme Court's First Division (Presiding Justice Oh Kyung-mi) upheld the original sentence of six months imprisonment with a two-year probation for Kim, who was indicted on charges of professional negligence causing injury and violation of the Medical Service Act. Kim was a first-year resident in Emergency Medicine in 2014 and was tried for discharging a patient who visited the emergency room on September 11 with symptoms of aortic dissection, mistakenly diagnosing simple acute gastritis, which resulted in the patient suffering from brain damage.

There was also a case where the responsibility of medical staff and the hospital was recognized after a patient suffered brain damage following emergency treatment for cardiac arrest in the emergency room. On the 19th, the 14th Civil Division of the Incheon District Court (Presiding Judge Kim Ji-hoo) partially ruled in favor of plaintiff A, an emergency patient, in a damages lawsuit filed against a university hospital foundation in Incheon. In April 2019, A visited the hospital emergency room with symptoms including abnormal breathing. The medical staff performed intubation after anesthesia as A’s respiratory rate was abnormal and consciousness was fading. Although a ventilator was attached afterward, A soon went into cardiac arrest. Cardiopulmonary resuscitation restored heartbeat, but A fell into a semi-comatose state due to 'hypoxic brain injury.'

Including Emergency Medicine doctors, more than two doctors on average per day in Korea are prosecuted for medical malpractice. According to a report titled 'Current Status and Implications of Criminalization of Medical Practice' released last year by the Korean Medical Association’s Medical Policy Research Institute, 6,095 doctors were prosecuted for professional negligence causing death or injury between 2011 and 2018, averaging 762 per year.

The medical community points out that if rulings ignoring the nature of medical practice continue, the emergency medical system could collapse. On the 27th, Lee Hyung-min, president of the Korean Society of Emergency Medicine, said at an emergency press conference, "Who would want to take charge of emergency medicine in a country where emergency patients are charged enormous costs and held criminally responsible regardless of the reason for their death?" He added, "The collapse of emergency rooms in our country has already begun."

Concerns are also emerging that the outlook for Emergency Medicine resident recruitment will become even bleaker. Lee Dong-chan, chief attorney at The Friends Law Office, said, "The 'Medical License Revocation Act,' which cancels the license of medical personnel sentenced to imprisonment or higher for general criminal law violations last month, is being enforced, increasing the burden of responsibility on medical personnel. It is expected to have the greatest impact on Emergency Medicine, where the risk of medical malpractice is high." Namgung In, professor of Emergency Medicine at Ewha Womans University, said, "Typically, we see 100 to 150 patients a day. In Emergency Medicine, diagnoses must be made directly, and there are many urgent situations, so the risk of medical malpractice is relatively high. Emergency room work has poor quality of life, and with lawsuits and the feeling that the state does not protect us, people are reluctant to enter Emergency Medicine."