After the Korean government announced the new placement of 2,000 entrants to Korean medical schools in 2025 [1], approximately 12,700 medical residents have resigned from their training hospitals since February 20, 2024 [2]. The majority have not yet returned to their hospitals. Initially, the government prohibited these resignations, but later reversed this stringent policy and permitted them. A deadline of July 15, 2024, was set for the residents to return to their hospitals, and hospitals were allowed to recruit new residents. By July 17, 2024, 110 out of 151 hospitals that employ medical residents had reported their resignation processing results. According to data from March 2024, 7,648 individuals, representing 56.5% of the 13,531 appointees, have either resigned or declined their appointments. Specifically, among interns, 2,950 out of 3,068 (96.2%) have resigned; among residents, the figure is 4,698 out of 10,463 (44.9%). For the latter half of this year, teaching hospitals have requested 7,707 positions for medical trainees, comprising 2,557 slots for interns and 5,150 for residents [3]. Most medical professors expect that few residents will return to the hospitals.
My primary concern in this situation is the burnout of clinical professors at university hospitals. These dedicated professionals tirelessly engage in patient care, educate medical students and residents, and conduct research. The recent mass resignation of medical residents has further strained these professionals, and it is crucial that we recognize and appreciate their dedication. Five months have already passed. Additionally, there is concern about the sustainability of university hospitals in their current state, as they face financial difficulties stemming from staff shortages caused by resident resignations.
Korean university hospitals are widely recognized for providing world-class medical services at very affordable rates, thanks to the national health insurance system. The potential collapse of these outstanding institutions would represent a significant loss to the medical community and raise concerns among the public about the accessibility and quality of healthcare services.
The Minister of Health and Welfare acknowledged during a National Assembly hearing that the decision to increase medical school admissions by 2,000 starting in 2025 was made without a scientific basis. This policy was formulated by the ministry without consulting medical associations or experts [4]. Since the founding of the Korean government in 1948, no previous administration has implemented such a severe policy that disrupts medical services and maligns the medical community without expert input. It is crucial for both the government and the public to reevaluate what is truly in the best interest of the health and happiness of the Korean people.
In this issue
Academic journals should be easily readable and engaging for a broad audience, not just experts in the field. Ewha Medical Journal, as a university publication, welcomes submissions from undergraduate and graduate students. This issue features a meeting report by an undergraduate student, Yerin Lee, which focuses on digital clinical medicine—a rapidly emerging field. Her insights as a medical student, rather than those of a practicing physician, offer an intriguing perspective [5].
This issue's special review section highlights three critical topics on infectious diseases in Korea: multi-drug resistant organisms, including carbapenem-resistant Enterobacterales (CRE) [6], influenza vaccines [7], and antiviral therapy for HIV/AIDS [8]. Drs. Do Hyeon Park and Pyoeng Gyun Choe from Seoul National University discuss the complexities of CRE spread, emphasizing that antimicrobial stewardship should be integrated with infection control strategies to enhance their effectiveness [6]. Dr. Joon Young Song from Korea University reports that high-dose and adjuvanted influenza vaccines have shown improved protection compared to standard-dose vaccines in elderly populations. However, the relative effectiveness of MF59-adjuvanted versus high-dose vaccines remains to be clarified. Despite high vaccination rates among the elderly, the limited effectiveness of current vaccines underscores the need for more potent and durable influenza vaccines specifically designed for this demographic [7]. Dr. Nam Su Ku from Yonsei University notes that over 1,000 new HIV infections have been recorded annually in Korea since 2013. Additionally, since the introduction of zidovudine, about 30 antiretroviral drugs have been approved for HIV treatment. He advocates for early and continuous antiretroviral treatment for all individuals living with HIV as an effective approach to maintain viral suppression and prevent the transmission of HIV [8].
Dr. Dong Wook Shin from Sungkyunkwan University has proposed the use of digital informed consent to standardize the physician's duty to inform, which is deemed a mission-impossible job e. He identified six content areas for digital informed consent and suggested storing these consent forms as non-fungible tokens (NFTs) on a blockchain. This idea stems from a ruling by the Supreme Court of Korea, which found a hospital at fault for not adequately fulfilling its duty to obtain informed consent by allowing insufficient time for the process. This innovative system aims to improve the process of obtaining informed consent, addressing existing challenges. While physicians, patients, and the government might initially be hesitant to adopt this new system, it offers a promising solution to relieve physicians from legal disputes related to their duty to obtain informed consent. Physicians strive to provide the best care for their patients, and facing severe penalties despite their best efforts could hinder their ability to serve. This topic warrants further discussion among all stakeholders involved.
Four protocols for reporting guidelines are introduced. Dr. Soo-Young Kim from Hallym University oversaw the development of these protocols, which focus on community outbreaks, surveillance reports, disease prevention recommendations, and survey reporting. These protocols will serve as the foundation for formal reporting guidelines and will be extremely beneficial for epidemiologists and field researchers.
Chang Ho Ahn at Lunit kindly provided correspondence entitled "My career path at a medical artificial intelligence company, working as a physician outside of clinical practice." Some medical students are interested in working at artificial intelligence companies, and Dr. Ahn's insights will help them understand this new career path as physicians [10].
Dr. Yongho Jee's case-crossover study explores the association between particulate matter and appendicitis in Korea [11]. It was found that patients with appendicitis had been exposed to higher levels of PM10 concentrations 3 and 7 days prior to their hospital admissions in the western area of Seoul. While the association of PM10 with appendicitis in boys under the age of 10 may be attributed to their higher breathing rates and immature immune systems, further research with a larger cohort is warranted. Maria Florencia Deslivia and colleagues have developed a new surgical technique involving the insertion of an interlocking screw during intramedullary nailing, utilizing a Steinmann pin and hammer [12]. This technique, tested using Sawbones femurs, shows promise for broader clinical application.
A focus group interview was conducted with six medical students from Ewha Womans University, who participated in an experiential entrepreneurship course from February 13 to 23, 2024 [13]. An analysis of the students' feedback on this innovative curriculum will inform decisions regarding its future implementation. The curriculum aims to enrich students' cognitive, emotional, and behavioral experiences.
It is currently difficult for clinical faculty members to write articles. I commend them for their academic dedication, despite their demanding responsibilities in patient care. I hope the issue concerning the "new placement of 2,000 entrants at Korean medical schools" is resolved efficiently and scientifically in the near future, allowing clinical faculty members to return to their normal routines amidst the current turmoil.
