[Viewpoint]Antidotes to the ‘sweet poison’

The fact that talented students tend to crowd into medical schools is not a recent phenomenon, but it’s happening to a more serious degree nowadays. Even medical schools in rural areas are full of students from the Seoul metropolitan area.
What happens is, those medical students do not stay in those areas after they graduate, but return home to do their internship training at large hospitals in the Seoul area.
Distinguished medical schools in rural areas have no other choice but to stand by and watch the talented people they produced sneak away to large metropolitan hospitals.
In recent years, the inclination of medical school graduates to conduct their internship training at hospitals in metropolitan areas has gone too far. The situation hollows the local hospitals in rural areas.
In addition, the tendency of excellent students to crowd into certain departments is getting worse, too. The competition is fierce in such departments as dermatology, ophthalmology and cosmetic surgery, which promise high pay and limited amounts of work. Meanwhile, departments that demand high-level skills in technology, knowledge and patience, such as general surgery, gynecology, laboratory works and chest surgery, don’t have enough applicants every year. If this continues, we might have to go overseas to get heart surgery in the near future.
We could put the blame on society, which pushes people to pursue economic affluence and leisure. Some young doctors these days think about quitting, without any regrets, if the department they choose does not fit their personality, no matter how good that department may be.
It is not rare to find interns give up their training with only two months left to go.
It’s understandable that doctors would want to avoid the general or chest surgery departments, which require hard work and are full of difficulties.
Unfortunately, however, such specialties can only be carried out when the person has a strong sense of duty and great skills. The honor of being a great doctor who saves people’s lives can be attained only after polishing knowledge and technical skills over a long period of time.
One of the reasons for this distortion is, above all, the unified medical fee system and shortsighted division of medical services by departments.
It is doesn’t make sense to pay for heart surgery, which takes seven to eight specialists half a day to conduct in an extremely tense atmosphere, with the same standards as a department which carries out dozens of surgeries that cost millions of won each every day.
On top of that, in heart surgery, patients sometimes need intensive care for weeks due to bad prognoses, creating a risk of potential medical disputes. That cold reality makes it hard to encourage students with a sense of duty to follow that vocation.
The equilibrium of compensation must be restored. Medicine is a service industry, too, and cannot be free of market principles. One system designed to help the phenomenon pays a subsidy of 500,000 won ($542) per month to interns in unpopular departments. However, it doesn’t make many doctors choose the tough departments.
The medical fee system should be made more realistic. That can happen when the distorted medical service division is fixed and reasonable economic rewards are provided to the doctors of hard-to-fill departments.
To do this, the related governmental departments and the medical world must reflect on themselves and agree on an innovative strategy.
Doctors were much less well off financially in the past, but they had a stronger future-oriented spirit, and were willing to accept challenges.
It was also a time when healthy competition was more socially acceptable. Doctors were armed with a strong sense of duty and humanism, as they had a passion to be the best.
However, the monolithic educational system, commercialized medicine and worship of money are like “sweet poison” to medical students. This is why I would like to recommend strong character education for students who wish to become doctors.
However, I also think the inclination of doctors to work in popular departments will change in the long run. It is regrettable that we temporarily lack enough talented students at major departments, but Korea’s general and chest surgery, gynecology and pediatrics medical technology are still the best in the world.
Therefore, if the present medical insurance policy is reconsidered and people start to change their way of thinking, our medicine will be able to be born as one that serves the people with global-class competitiveness.

*The writer is a professor of pediatric cardiothoracic surgery at Seoul National University.

by Lee Jeong-yul