“We will accept trauma patients from the Incheon area under any circumstances. Even if transport requests come from other areas like Seoul or Gyeonggi, we will accept any patient whose life is in immediate danger. We believe that if we don't help, this patient cannot survive.”
On the 17th, Hyun Sung-yeol, the head of the regional trauma center at Gachon University Gil Medical Center in Namdong District, Incheon, said, “The fact that transport requests for Seoul and Gyeonggi patients have reached us means there are no more options available. We try to accept as many patients as possible with the thought that we need to at least save their lives.”
On that Monday morning at 8 a.m., Hyun hurried to the conference room. It was a meeting to check the status of patients admitted over the weekend. The meeting room was filled with about 30 trauma specialists and nurses. Among the more than 20 patients discussed in that meeting, one-fourth were involved in accidents outside Incheon, such as in Yangcheon District in Seoul and Suwon and Yongin in Gyeonggi.
A trauma surgeon who worked over the weekend explained, “A structure fell on a person’s head in Mokdong, Seoul, causing severe bleeding and a saturation level that dropped to 78, but there was no hospital able to accept him immediately, so he ended up coming to our center.” Hyun sighed, saying, “Now we are receiving patients from all over the metropolitan area.”
Seventeen regional trauma centers across the country operate 24 hours a day, 365 days a year, so that patients exhibiting severe trauma from traffic accidents, falls, blunt force injuries, and self-harm can receive immediate surgical treatment. However, patients flood into Gil Medical Center from all over the metropolitan area, including Yangcheon, Geumcheon, and Guro districts in Seoul, as well as Gimpo, Bucheon, Suwon, and Yongin in Gyeonggi. The trauma center at Gil Medical Center serves as a final bastion not only for Incheon but for the entire metropolitan area.
Hyun pointed out that the imbalance of medical personnel between trauma centers is a crucial reason for the issues. He noted, “While thoracic surgeons and orthopedic surgeons are essential in trauma centers, often only one emergency medicine doctor works in most centers, except for a few. Although government support for personnel costs is keeping the hospitals operational, the manpower shortage remains unresolved.”
The recent issue of personnel shortages in essential medical fields has been particularly critical in trauma surgery, which is considered a less popular specialty. To become a trauma specialist, one must graduate from medical school, complete over 10 years of training in surgery, thoracic surgery, orthopedics, and neurosurgery fellowships, and then choose trauma surgery as a subspecialty, requiring an additional 2 years of learning.
Hyun said, “Trauma specialists have been labeled as a ‘money-losing specialty,’” and explained, “The long training period results in only about 4 trainees at a time, and coupled with conflicts in the medical community, last year was the last time we had one new entrant.”
Medical staff at trauma centers also face significant burdens from medical lawsuits. Hyun mentioned, “There are cases where medical personnel are sued simply because the surgical scars are prominent,” adding, “Even though lives were saved, lawsuits continue, and even a suspended sentence can lead to the revocation of a doctor’s license, which needs to change.”
Hyun stated, “Simply increasing the number of doctors does not resolve the personnel shortage in essential medical fields,” and emphasized that “it’s obvious, but we must address the reasons why trainees avoid trauma centers.”
He is a doctor with 38 years of experience since obtaining his medical license in 1988. He spent most of his medical career in emergency medical centers (emergency rooms). During that time, he became a specialist in thoracic surgery and emergency medicine, as well as a subspecialist in critical care and trauma. He moved to the trauma center after the first regional trauma center opened at Gil Medical Center in 2014. Since last year, he has been the head of the center.
Hyun is known as a seemingly stoic professor who doesn’t smile much, similar to Kim Sa-bu from the TV drama “Romantic Doctor Kim Sa-bu.” Even during the morning rounds, he doesn’t speak gently to patients. He only asks essential questions like, “Can you walk? Do you have any pain?” and leaves.
Once he leaves the patient room, his demeanor changes immediately. He earnestly asks doctors and nurses to keep a close eye on “whether that patient feels dizzy when walking.” He also expresses encouragement by buying coffee for the medical personnel joining the rounds and having a tea time together.
Hyun mentioned that his two years of experience working at a rural health center the year after obtaining his medical license drew him to this trauma center. He visited elderly patients who had difficulty traveling to hospitals while walking around his village from the health center in Naju, Jeollanam-do. He found it hard to leave elderly patients needing treatment, which extended his working period beyond his plans.
As a result, he started his residency two years later than his peers. Hyun explained that he chose the trauma center after emergency medicine because he realized that emergency patients who suddenly face incidents, like elderly patients in the countryside, may not receive treatment unless someone seeks them out. He said, “Even if I can’t save everyone who comes to me, I will treat them with the mindset that our center is their last option.”