ArticleKorean journal of clinical oncology2025
Resident shortages and their impact on surgical care, defensive medicine, and patient management: a retrospective study in South Korea.
Article in Korean journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Addressing low-value care (LVC) in Asia: a narrative review of Choosing Wisely and other initiatives across Asia.BMJ open quality · 2026Review
- Burnout among Korean Neurosurgeons Following a National Trainee Withdrawal during 2024-2025 Medical Crisis in Korea.Journal of Korean Neurosurgical Society · 2026Article
- Resident Physician Walkout and High-Incidence Cancer Operation Volumes in South Korea.JAMA network open · 2026Article
- Allocative inefficiency in physician workforce distribution: specialty-level NHI-covered reimbursement analysis in South Korea's single-payer system.Frontiers in public health · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
purposeThis study aimed to evaluate the impact of declining surgical residency program enrollment on patient care and outcomes in colorectal cancer surgeries.
methodsThis retrospective observational study included 676 patients (410 males; median age: 69 years) who underwent colorectal cancer surgery at Pusan National University Hospital between January 2018 and June 2024. Patients were divided into Group A (before December 31, 2023; with residents) and Group B (after January 1, 2024; without residents). All surgeries were performed by a single attending surgeon.
resultsPreoperative variables were comparable between groups. Group A had more emergency and open surgeries, and a higher proportion of advanced-stage cancers. Overall complication rates were similar, but Group B had a longer hospital stay (9.72 days vs. 11.95 days). Specific complications such as anastomotic leakage and surgical site infections differed significantly. The overall number of surgical procedures declined markedly in 2024 compared to 2018 (77.1% vs. 49.9%).
conclusionThe absence of residents did not increase overall complication rates but was associated with longer hospital stays and shifts in clinical practice. Greater reliance on attending surgeons contributed to more defensive decision-making and conservative patient management. Addressing these issues requires systemic reforms, including multidisciplinary collaboration and legal protections to improve surgical care.
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