[Inside Chodong] University Hospitals in March

"Until February 28, I was a medical student, but from March 1, I'm an intern. I know nothing, yet in just one day, I'm an intern and the attending physician. (From the drama 'Hospital Playlist')

There used to be an unspoken rule that one should avoid being admitted to a university hospital in March when the new semester begins. This is because new interns who have just graduated from medical school start, and those who were interns last year become residents and begin seeing patients. This period is the most chaotic in hospitals and prone to various accidents. From the patient's perspective, there is a high chance of being examined or treated by a 'rookie doctor.' Incidents such as interns unfamiliar with blood draws poking the needle multiple times, or taking an X-ray of the left arm first when the right arm is broken, are considered minor mishaps.

However, such stories may soon become a thing of the past. Due to the medical-government conflict lasting over a year, there are no longer any interns or residents in university hospitals. Only exhausted professors and fellows, worn out from frequent on-call duties, remain on site, complaining of severe fatigue and burnout. Many residents who left the hospital without completing their training have spent the past year working mainly as 'general physicians' at other small and medium-sized hospitals. From a doctor's perspective, it is difficult to learn advanced procedures like those at training hospitals (university hospitals), but they can care for many patients in clinical settings. From the hospital's perspective, they could hire doctors at lower salaries than specialists, so at first glance, it seemed not to be a problem. However, in the unresolved situation, it is unlikely that these general physicians (former residents) will return to university hospitals, where they would face harsh workloads and low pay again.

Even the remaining doctors are moving from rural areas to the metropolitan area, and from the metropolitan area to Seoul, causing medical staff shortages in hospitals. Those who stay in understaffed regional hospitals face heavier workloads, so they tend to move in succession to larger and more prestigious general or tertiary hospitals. A professor at a regional university hospital lamented, "Until last year, fellows who still had contracts stayed, but at the end of the year, they moved one after another to Seoul and the metropolitan area," adding, "This year, there are no new specialists, so some departments even have to reduce outpatient services."

Given this situation, resuming medical school classes is unthinkable. University hospital professors juggle patient care and lectures, and ironically, the reason they managed to see patients despite the staff shortage over the past year was because there were no medical school classes. However, unlike last March when there was hope for a resolution, this year faces an even greater challenge of educating many students who are on leave as well as many new students all at once.

Patients suffer the most. Initial appointments at tertiary hospitals require waiting for months, and even if they manage to see a professor, there is no guarantee of timely surgery. An analysis showed that over 3,100 excess deaths occurred between February and July last year due to inadequate treatment caused by the medical-government conflict. Now, South Korea's healthcare cannot return to its previous level without resolving repeatedly mentioned issues such as the return and improved treatment of interns and residents, strengthening essential and regional healthcare, and realistic medical fees. The first practical step toward a solution is agreeing on medical school quotas and normalizing classes. Considering next year's admission schedule and medical school start dates, this March is even more critical.