Sustaining surgical services during the 2024 South Korean medical workforce crisis: a single-center experience

In early 2024, South Korea experienced a historic disruption in healthcare services following the mass resignation of over 92% of medical residents in opposition to government plans to expand medical school admissions [1][2][3][4][5].At International St. Mary's Hospital, a secondary-level teaching hospital, the resignation of all anesthesiology residents and three faculty members critically endangered surgical service continuity.In response, we implemented several institutional strategies focused on workflow optimization and staff support.First, turnover time related to anesthesia was reduced by 23% through standardization of operating room cleaning, improved patient transport logistics, and streamlined interdepartmental coordination.These measures also reduced staff overtime by 53%.Second, faculty well-being was prioritized.Private offices were allocated to all anesthesiology faculty, replacing shared spaces.This improvement significantly enhanced job satisfaction and resulted in a 200% increase in faculty recruitment applications.Salaries were raised by 20% to match national benchmarks, helping secure faculty retention.To support team morale, a "Compliment Board" was introduced in the operating room to encourage peer recognition.In addition, the Local Hi-Pass program was established, enabling minor procedures under local anesthesia without prior anesthesiology approval.This led to a 16.9% increase in such procedures.Consequently, we reopened an additional general anesthesia operating room and successfully recruited five new anesthesiology faculty members, resulting in a net staffing increase.Our experience highlights how proactive, staff-centered strategies and institutional agility can help sustain surgical services during systemic healthcare crises.