Professional identity erosion and intention to leave among spine surgeons during South Korea’s 2024 healthcare crisis

Physician burnout is a growing global concern, yet its link to acute healthcare-policy crises remains poorly understood. In February 2024, the South Korean government unilaterally announced a 65% increase in medical school enrollment quotas without professional consultation, prompting more than 12,000 trainees to resign and shifting clinical burdens onto attending surgeons. We surveyed approximately 850 members of the Korean Spine Surgery Society in November 2024, measuring burnout with the 12-item Korean Burnout Assessment Tool (K-BAT). Of 122 respondents, 117 formed the analytic sample, with 41 (35.0%) at high risk for burnout and 62 (53.0%) reporting intention to leave. Erosion of affective professional pride was most consistently associated with intention to leave (adjusted odds ratio 4.75; 95% confidence interval 1.14–19.85; P = 0.03), whereas workload variables and overall burnout severity were not independently associated after adjustment. These imprecise estimates were directionally robust under Firth penalized analysis but remain exploratory. Within the burnout construct, mental distance predominated over exhaustion. This pattern is more consistent with moral injury, psychological harm arising when a system transgresses deeply held professional values, than with workload-driven burnout, although moral injury was not directly measured. We hypothesize that policy interventions prioritizing professional identity preservation during healthcare crises may support surgeon retention, warranting prospective evaluation.