Practice of Critical Care in South Korea

Gee Young Suh, MDDepartment of Pulmonary and Critical Care Medicine

Samsung Medical CenterSungKyunKwan 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 medicine the basic skills necessary to become intensivists