Broadcast date: Friday, August 18, 2023, 10 PM When our children get sick, pediatricians who can treat them are disappearing. According to the Ministry of Health and Welfare, the final application rate for pediatric residency this year was 25.5%. The application rate for upper-year residents in the second half of the year is even more miserable. The total number of applicants for 40 training hospitals nationwide was 258, but there were only 2 applicants. Pediatrics, an essential medical subject, has already been driven to the brink. What is the cause of the collapsing pediatric medical system, and what is the solution? ■ Doctors who protect the front lines of children's lives, "We're losing doctors who can perform pediatric heart surgery." Every year, more than 2,000 children undergo heart disease surgery. However, there are only 15 specialists in the country who can perform pediatric heart surgery. Professor Kim Woong-han of Pediatric Thoracic Surgery is one of them, a veteran surgeon who has made children's hearts beat again for over 20 years. The production team met Professor Kim in an operating room of a large general hospital. Professor Kim, who only thinks about the success of his child’s surgery before he even performs it, came out of the operating room seven hours after he entered it. As soon as he successfully completed the surgery, Professor Kim went to see an outpatient clinic without taking a breath. He is worried that his physical strength is declining as he has accumulated experience. However, his biggest worry these days is something else. Will there be no doctors to take over after he retires? There have been zero doctors applying for the pediatric thoracic surgery residency at this hospital for three years. According to Professor Kim, this hospital was the ‘last bastion’ in Korea. Most of the ten or so specialists currently in charge of pediatric heart surgery are in their 50s like Professor Kim. What will happen to the over 2,000 small hearts after they retire? “It’s been three years since (the residency application) was cut off. There are none nationwide. If things continue like this, there will be no more doctors in our country who can perform congenital heart disease surgeries.” Professor Kim Woong-han of Pediatrics and Thoracic Surgery - “They are dreamers specializing in pediatric neurosurgery. There are currently two in the entire country. There are no applicants… Because there are no applicants, the training system is collapsing.” Professor Pi Ji-hoon of Pediatrics and Neurosurgery - The situation is not much different for pediatric neurosurgery, which deals with cerebrovascular diseases. Lee Jong-seok, a resident of pediatric neurosurgery, one of only two in the entire country, said, “I feel half burdened and half worried,” and “I don’t want to end the lineage of pediatric neurosurgeons because of my mistake.” ■ The already collapsed local pediatric medical system… Critically ill patients travel 300km to the hospital Kim Ji-yu, who lives in Gwangyang, Jeollanam-do, heads to Seoul every week with a bottle sterilizer that is bigger than a microwave. It is for her son, Si-hoon, who is only 9 months old, to receive cancer treatment. The whole family drives from Gwangyang to Seoul, a journey of over 4 hours. When the hospital notifies him that he can be admitted, Si-hoon says that if he leaves, it will be too late and he will miss the hospital room, so he comes up the night before and spends the night at an unfamiliar motel. This time, it took a full half day to be admitted. Si-hoon has to visit a hospital that is over 300km away. For critically ill children in the countryside, the road to the hospital and the road to health are daunting. “The countryside is now completely underwater. The typhoon came and only Seoul is rising... The water is rising here too, and it’s becoming a vicious cycle because we can’t see the patients.” Professor Ko Kyung-nam, Department of Pediatric and Adolescent Oncology and Hematology - ■ Shortage of resident doctors... Professors are on duty, and secondary hospitals are overloaded Professor Yang Yu-jin of the Department of Pediatric Hematology and Oncology finished his outpatient treatment again today without eating lunch. However, he went straight to the medical department to prepare for his duty. As the number of pediatric residents is decreasing, 75% of hospitals are having professors personally work overnight to provide treatment. Professor Yang’s hospital currently has five residents, but they are all scheduled to leave the country by February of next year. The doctors the production team met all agreed that “next year is really concerning.” How did pediatrics become a subject to avoid? The production team asked the pediatric residents why. “The survival rate for pediatric cancer patients is high, approaching 70-75%. Whether we can maintain this level of success… is something that will have to remain a question mark from now on.” “More and more patients are piling up in the intensive care unit. ‘I’m alone, but which of these seriously ill patients should I go to first?’ I can’t count the number of times I’ve cried while working because it was so hard to see the patients.” Pediatric resident A - The shortage of pediatric residents is not just a problem for large general hospitals. It is spreading to children’s hospitals, which are secondary hospitals, and neighborhood clinics, which are primary hospitals. We visited a children's hospital where the chain reaction is already occurring. Originally, children's hospitals served as the backbone of the pediatric medical system and were responsible for mildly and seriously ill patients. However, recently, as general hospital emergency rooms stopped accepting pediatric patients, emergency and seriously ill patients have been flocking to this place. In the end, even children living in Seoul are coming all the way to Cheonan, South Chungcheong Province, to receive emergency treatment and be hospitalized. Among the 45 general hospitals nationwide, only 12 have 24-hour emergency rooms for children, and the weight of this reality is being felt by children's hospitals. "In 2013, children's hospitals accounted for only 18% of the total. But now it's up to 24%. That means we're seeing patients beyond our capabilities. Now, it feels like a 'second-and-a-half hospital.'" Director Choi Yong-jae of Children's Hospital - Professor Yang Yu-jin of Pediatric Hematology and Oncology - ■ Pediatrics Open Run? “Because everyone else is gone... I survived COVID-19, so I’m seeing patients now.” At 9 a.m., before the hospital even opened, a long line formed in front of the children’s hospital, like something you’d see on a social media hotspot. The so-called “pediatrics open run” has become a natural thing among parents. As soon as the hospital opened, patients and guardians poured in like a flood. When the production team asked why, Director Lee In-gyu of the Children’s Hospital showed the negative pressure machine he had prepared during the pandemic instead of answering. Over the past five years, more than 600 pediatric and adolescent departments have closed, and pediatric and adolescent departments were hit hard by the decrease in patients due to COVID-19. Director Lee’s hospital could not avoid this either. In the end, all employees took turns taking paid leave for nine months to barely make it. The production team met with Lee Jong-won, who couldn’t stand it anymore and eventually took down the pediatrics sign that he had run for 25 years. “2020~2021 was probably the worst (for the hospital)... The number of patients per day decreased by one-tenth. The reason why patients flock here is because everyone else is gone. It’s sad, but I survived that time and am seeing patients now.” Lee In-gyu, Director of Children’s Hospital - “‘What did I do wrong?’ I also think about this and realize how serious the declining birth rate is in our country.” Lee Jong-won, Pediatrics and Adolescent Medicine Specialist - ■ The Future of Pediatrics and Adolescent Medicine, Can We Protect Our Children’s Future? The Collapse of the Pediatric Medical System, Is There No Solution? The production team visited Japan to get some clues. In 2007, Japan introduced a medical school entrance exam system called the “Regional Quota System” to solve the regional medical gap and essential medical personnel problems. This is a system where the government and local governments support tuition and training costs, and if you work in the region for 9 years after obtaining a medical license, you are exempt from paying the fees. Japan has raised the regional survival rate to 99% by taking measures such as preventing specialists from obtaining qualifications if they leave the region during their mandatory service period (as of 2018, Ministry of Health, Labor and Welfare). In addition, Japan is making efforts at the national level, such as enacting the Basic Act on Childcare, which contains the philosophy that “the country is responsible for the health of children,” for the pediatric medical system, and establishing the Child and Family Agency under the direct control of the Prime Minister. Takuya Masuda, who entered medical school through the regional quota system and has been serving in Tochigi Prefecture, which is considered a medically underserved area in Japan, for nine years, said, “I found a role that I can play in that region” during his mandatory service period, and “I plan to remain in the region and work there in the future.” The episode “The Disappearance of Doctors, the Collapse of Pediatrics Is Coming” will air on KBS1TV at 10 p.m. on August 18. Since 1983, Korea's first investigative program Tracking the truth with the eyes of common sense Every Friday at 10 PM KBS1 《Tracking 60 Minutes》 ✔ Tips: 010-4828-0203 / Tracking 60 Minutes homepage / [email protected] ▶Homepage: https://program.kbs.co.kr/2tv/culture... ▶KakaoTalk Channel: http://pf.kakao.com/_fxgiyxj ▶Facebook: /kbs60min ▶Instagram: /kbs60min ▶Twitter: /kbs1548553