Practice of Critical Care in South Korea

Gee Young Suh, MD

Department of Pulmonary and Critical Care Medicine

Samsung Medical Center

SungKyunKwan University School of Medicine

Seoul, Korea

Types of ICU

• Open vs closed

– Many hospitals employ open system

– Some hospitals employ closed system in selec

ted ICU’s

Training of ICU Physicians

• No formal training in critical care medicine

• Chief of ICU

– Surgical or multidisciplinary ICU: many anest

hesiologist, surgeons

– Medical ICU: pulmonologist, cardiologist

– Coronary care unit: cardiologist

Formal Training• Just few hours of clinical clerkship for medical

students at most universities

• Residents– No formal guideline for training residents in critical care

– In 2001, working group to form a formal guideline was established by Korean Society of Critical Care Medicine

• Fellows– No formal guideline

– Different levels of training in different hospitals

Key Clinical Decision Makers• Intensivist

– Ventilator and hemodynamic decision making

– Admission and discharge decisions

• Attending physician– Family counseling

– Treatment of specific diseases

• Fellow/House residents– Day-to-day care of patients

Problems Hindering Development of Critical Care in Korea

• Low cost of critical care

– Most hospitals: private

– Medical costs: set and controlled by the government

– Administrators see ICU’s as money-losing department

• Few true intensivists

– Even active interested doctors cannot devote full time to the ICU

• No formal training or guideline in critical care

Pressing Educational Needs

• More physicians devoted to critical care me

dicine are needed

– Teach physicians and administrators why intens

ivist-directed ICU’s are important and necessary

– Educate physicians interested in critical care me

dicine the basic skills necessary to become inte

nsivists