Former lawmaker Park In-sook is a pediatrician specialist who was called Korea’s number one in the pediatric heart field before being re-elected. After graduating from Seoul Medical University, she worked as an assistant professor of pediatric cardiology at Baylor Medical University Children’s Hospital and Texas Heart Hospital in Houston, Texas, USA. She last returned to Korea in 1989. Since March she has been working as a pediatric and adolescent cardiology professor at Asan Hospital in Seoul. Written by former lawmaker Park <선천성 심장병>is called a textbook in the field of congenital heart disease. She was also the first woman to serve as the dean of Ulsan Medical College.
The drastic drop in support for pediatrics majors is just one expression of a series of catastrophes called ‘population collapse, national extinction’. The root cause is the low birth rate. All the governments have poured astronomical taxes, saying they are worried about the low birth rate, but the hundred medicines are invalid.
The government’s low-birth rate measures only provoked resistance from young people, especially women. The number of births per year is 200,000, the lowest ever, and the total fertility rate is 0.81 per woman of childbearing age, the lowest in the world. It is not possible to maintain the state as it is.
Finally, what was to come had to come. There were concerns about a pediatric treatment crisis due to the Corona 19 pandemic, but now the number of hospitals where sick children are hospitalized has decreased, and it is almost impossible to receive medical treatment at night or on weekends.
The application rate for minors and majors has fallen rapidly every year, and the application rate in 2023 is less than 17%. Many university hospitals do not have applicants for majors in small departments at all.
Now, instead of short-sighted measures to increase the recruitment rate of pediatric majors, appeals and nurturing measures, and more importantly, ‘shocking’ level of low birthrate measures should be introduced. The biggest reason why medical school graduates do not choose Socheonggwa is that they do not see any hope for the future.
Whether you are a practicing doctor, a hospital service doctor, or a university professor, we will list various situations where the future of the department does not look bright.
① Unlike internal medicine, which deals only with patients (sometimes with spouses or children), socheong department has to communicate with not only children but also parents, and sometimes grandparents and relatives. Therefore, in many cases, they receive a great mental burden from them, and in rare cases, they are exposed to violence. Some suffer unfair damage in online communities such as Mom Cafe, but once damaged in such a place, it is difficult to recover.
② The unreasonable insurance fee system also makes appeals more difficult. Take, for example, an intravenous injection or a blood draw. For children, this procedure is technically many times more difficult and time-consuming than for adults. They require more variety of equipment and are more expensive. In addition, if the child cries, the emotionally charged parent may become dissatisfied. However, all insurance rates are the same. In addition, the risk of violence and even lawsuits is high.
In addition, various types of instruments, medicines, and injections used for all procedures or treatments for children are required in various sizes. It is not necessary to prepare only one size like adults do, so the cost burden is high, but health insurance does not consider this.
③ Diagnosis, examination, and treatment are more difficult than adults. Even the simple act of looking into the ear or throat, for example, takes extra time, effort, and patience because children are many times more difficult and less cooperative than adults. In the process, conflicts with parents may arise. Health insurance fees do not take this into account. In addition, these difficulties result in more dissatisfaction and a higher risk of lawsuits than adults.
④ Ewha Womans University Mokdong Hospital’s neonatal death case, due to the arrest of medical staff, the phenomenon of appeal and avoidance intensified. In the end, all of them were innocent until the Supreme Court’s final verdict, but this case left irreversible and deep trauma to medical personnel, especially the appeals department, and furthermore, neonatology doctors who took a high risk. And it deepened the phenomenon of avoidance of the neonatology major, which was seriously lacking.
⑤ Pediatrics is a study that encompasses ‘all the studies learned in internal medicine + birth, growth, and development’. Children are not simply miniature adults. Children have unique characteristics for each organ and organ. So, just like internal medicine and surgery, the Department of Chemistry has detailed majors for each organ and organ. Pediatric Cardiology, Pediatric Kidney, Pediatric Respiratory/Allergy, Pediatric Gastroenterology, Pediatric Neurology, Pediatric Oncology, Neonatology, Critical Care, and Pediatric Emergency Medicine.
However, compared to internal medicine, there are far fewer opportunities to actively utilize small and medium-sized departments even if they specialize. It is difficult to remain as a professor at a university, and there are fewer opportunities to take advantage of it once a university opens. Even many ordinary people do not even know that there is a sub-major in small greens. Therefore, young doctors who want to further enhance their academic achievement with a specific major usually choose internal medicine instead of pediatrics. Pediatric sub-specialists are essential, but since the number of patients in each field is small, it is impossible to secure all pediatric sub-specialists at each university or general hospital.
There are these reasons behind recent media reports that it is difficult to treat childhood cancer patients in rural areas. The shortage of specialists in pediatric subspecialties will become more serious in the future.
⑥ In large hospitals and university hospitals, for the reasons listed above, small fruits and vegetables do not greatly help hospital profits, and even receive painful criticism that small fruits are part of the hospital deficit. This greatly hurts the self-esteem of appellate doctors and becomes a reason for avoiding the appellate major. For the same reason, investments in pediatric personnel and facilities are being reduced or even eliminating children’s hospitalization rooms.
⑦ Now, doctors also consider various careers such as pharmaceutical companies, bio companies, public health centers, government agencies, research institutes, journalism, and (after retirement) nursing hospitals, in addition to traditional careers such as open practice, service doctors, and university professors after training. However, when you majored in small fruits and vegetables, the range of choices is much more limited. If you have this intention, it would be much more advantageous to choose internal medicine or surgery. Although it is a small part, this point can also be a reason to avoid small fruits and vegetables.
⑧ When a resident quits midway, the workload of the remaining resident surges. As a result, the vicious cycle of avoiding the application of majors has already accelerated over the past few years. It is difficult to reverse this phenomenon right now.
The gap in pediatric care is of great concern. Despite the poor medical treatment and research environment, in fact, what many doctors feel proud of is the love for children, the joy when young children overcome difficult illnesses and are cured, and the fact that children will live much longer than adults. It is that it has a much greater reward and joy in it. However, we cannot expect such a ‘beautiful mind’ and sacrificial spirit from the doctors of the Department of Appeals forever.
Pediatric extinction, population extinction, and national extinction are all national catastrophes in the same context. A ‘revolutionary’ solution is needed.