1Institute of Medical Education, Hallym University College of Medicine, Chuncheon, Korea
*Corresponding author: Sun Huh,
Institute of Medical Education, Hallym University College of Medicine, 1
Hallymdaehak-gil, Chuncheon 24252, Korea, E-mail:
shuh@hallym.ac.kr
• Received: July 23, 2024 • Accepted: July 25, 2024
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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.
Authors' contributions
All work was done by Sun Huh.
Conflict of interest
Sun Huh has been the editor of the Ewha Medical Journal since
September 2023. However, he was not involved in the peer review process or
decision-making. Otherwise, no potential conflict of interest relevant to this
article was reported.
Funding
Not applicable.
Data availability
Not applicable.
Acknowledgments
Not applicable.
Supplementary materials
Not applicable.
References
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2025: is the government’s policy evidence-based? Ewha Med J 2024;47(2):e13.
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7,648 residents in training hospital… applications for 7,707
recruitment in the second half of the year” [Internet]; Sejong (KR): Ministry of Culture, Sports, and Tourism; c2024 [cited 2024 Jul 22]. Available from: https://www.korea.kr/news/policyNewsView.do?newsId=148931658
4. National Assembly Minutes. Committee of Health and Welfare [Internet]; Seoul (KR): National Assembly; c2024 [cited 2024 Jul 22]. Available from: https://likms.assembly.go.kr/record/#none
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multidrug-resistant organisms in Korea: a focus on carbapenem-resistant
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physician’s duty to inform, a mission-impossible job. Ewha Med J 2024;47(3):e33.
10. Ahn CH. My career path at a medical artificial intelligence company,
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during intramedullary nailing using a Steinmann pin and hammer: a
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How a medical journal can survive the freezing era of article
production in Korea, and highlights in this issue of the Ewha Medical
Journal Ji Yeon Byun The Ewha Medical Journal.2025;[Epub] CrossRef
Halted medical education in Korea amid Nobel Prizes in deep learning
and machine learning research, tribute to a leader of Ewha Womans University
College of Medicine, and highlights from this issue Sun Huh The Ewha Medical Journal.2024;[Epub] CrossRef
