Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea

Abstract

Background: Pediatric cardiologists (PCs) and pediatric cardiac surgeons (PedCSs) in Korea face growing work force shortages due to declining birth rates, decreasing interest among trainees, and increasing burnout. Purpose: This study investigated the working conditions, job satisfaction, and burnout levels among Korean PCs and PedCSs. Methods: In June 2023, the Korean Pediatric Heart Society distributed a structured questionnaire via email to 149 members actively practicing pediatric cardiac care (115 PCs, 34 PedCSs). Responses from 122 members were analyzed. Descriptive statistics and regression analyses were performed to identify the factors associated with burnout (P<0.05). Results: A total of 122 physicians (96 PCs, 26 PedCSs) completed the survey (response rates: overall, 81.9%; PCs, 83.5%; PedCSs, 76.5%). Among the PCs, 79.2% worked more than 51 hr/wk, 57.3% worked night shifts, and 70.8% perienced emergency callbacks at least once per month. PedCSs reported comparably heavy burdens, with 80.8% working >51 hr/wk and 88.5% experiencing monthly emergency callbacks. Regional disparities were notable: 48.2% of PCs in the Seoul metropolitan area (SMA) per formed >51 catheterizations annually versus 7.1% in other regions, while 62.5% of PedCSs in the SMA performed >30 surgeries annually versus 20% elsewhere. Litigation, reported by 66.7% of PCs versus 84.6% of PedCSs, contri buted to dissatisfaction and burnout. The key drivers included limited research time, legal risks, and nonspecia lized duties. Overall, 64.0% of the PCs and 61.6% of the PedCSs reported experiencing burnout. In the multivari able analysis, answering >= 6 emergency callbacks/mo justed odds ratio [aOR], 7.91; 95% confidence interval 1.28-48.79), occupational dissatisfaction (aOR, 2.57; 1.09-6.04), and work environment dissatisfaction 2.74; 95% CI, 1.16-7.14) independently predicted burnout, whereas the working >51 hr/wk variable did not significant postadjustment. Conclusion: Excessive workload, frequent emergency callbacks, regional maldistribution of case volumes, tion pressure, and occupational dissatisfaction drive burnout among Korean pediatric cardiac specialists. These findings highlight persistent workforce challenges in Korea&apos;s pediatric cardiac system. Regular surveys ongoing research are essential to ensuring sustainable pediatric cardiac care.