Forensic agency suffers medical examiner shortage as doctors shun profession

The National Forensic Service (NFS) is suffering an acute shortage of medical examiners even as the government moves to increase the enrollment quota at medical schools.

The entrance of the National Forensic Service building in Wonju, Gangwon [LEE YOUNG KEUN]

The National Forensic Service (NFS) is suffering an acute shortage of medical examiners even as the government moves to increase the enrollment quota at medical schools.

Over the last two years, only one medical examiner was hired through a recruitment process.

The NFS posted a job notice to recruit six medical examiners to inspect autopsies on Feb. 1, but nobody applied.

Nor did anyone apply when the institute posted recruitment notices twice last year, either.

The shortage is burdening the current medical examiners at the institute.

The NFS received 8,059 autopsy requests last year, but it has only 33 medical examiners, far below the institute’s required quota of 49.

That means each medical examiner must conduct 244 autopsies a year.

“There are weeks when I can't rest even a day because often I have to meet investigation officials to review documents and testify in court,” a former NFS medical examiner told the JoongAng Ilbo, an affiliate of the Korea JoongAng Daily.

The NFS is getting help from private medical experts for autopsies to fill in for the lack of staff.

In 2022, 33 percent of the requests were conducted by outside medical experts.

A continued absence of essential middle-level employees worsens the situation.

A total of nine medical examiners resigned before reaching their retirement age in the past five years, according to the NFS.

“The labor force has resembled an hourglass for quite some time,” said Yang Kyung-moo, the head of NFS’s forensic medicine department.

“The departure of experienced individuals has impeded the mentoring process and hindered the progress of tasks.”

“Most NFS institutes outside of Seoul have only one or two medical examiners,” Yang added.

“Examiners feel greatly burdened when they are suddenly sent to somewhere unfamiliar when there is a resignation or leave of absence in those places.”

Some people blame the shortage of low salaries.

NFS medical examiners need medical licenses.

When medical examiners enroll, they are hired as grade V public officials in professional service and earn 80 million won ($61,080) annually. After 10 years, they are promoted to grade IV and earn around 100 million won.

However, that salary is far lower than that of other general doctors, who earn an average of 230 million won yearly, according to the Ministry of Health and Welfare’s 2020 report.

“Stressing the sense of duty when they earn less than their peers is useless,” Prof. Yoo Seong-ho of Seoul National University’s Department of Forensic Medicine said.

The number of students majoring in pathology is dwindling, another reason for the shortage.

Most medical examiners and forensic pathologists are medical specialists in pathology.

However, the number of trainee doctors applying for the major fell short yearly as students were reluctant to study the field.

According to the Health Ministry, the applicant rate was 38.8 percent in 2022, 50.6 percent in 2023 and 60 percent this year.

These rates are similar to those of essential fields also suffering shortages, such as obstetrics and gynecology and emergency medicine.

“In the past, there were so-called ‘nerds’ who studied forensic medicine regardless of their parent's approval,” a forensic specialist who asked to be anonymous told the JoongAng Ilbo.

"However, fewer students have been studying the field recently, as most are good students who are also strongly influenced by their parents."

“As society ages, the number of deaths will increase, leading to an increase in demands for autopsies,” said Seo Joong-seok, former director of the NFS.

“More wrongful deaths will increase if we refuse to pay attention to forensic medicine, which is a field that plays an essential role in medicine.”

The insufficient authority given to medical examiners also discourages them from pursuing their careers.

“There are times when we want to check the actual case site during an autopsy,” said Prof. Kim Youn-shin at Chosun University’s Medical Science Department, who worked at the NFS in the past.

“However, we often had to give up because related agencies, such as the police, did not cooperate as much as we'd hoped.”

"Medical examiners inevitably become discouraged as they constantly run into such problems," Kim added.

Yang also pointed out that the examination system needs to be improved, citing that “the current system does not allow medical examiners to view the medical records of the dead if the deaths have yet to be registered.”

The majority of the forensic medicine field believes there will be “no groundbreaking change” even if the government’s plan to increase the enrollment quota for medical schools becomes a reality.

“Forensic medicine contributes across the national health spectrum in addition to judicial autopsies that reveal criminal links,” said Kim Yu-hoon, president of the Korean Society For Legal Medicine.

“But the field is always pushed back on the priority list due to the strong perception that the living comes first.”

“Most NFS applicants are trainee doctors who have practiced for almost 10 years,” Yang said.

"If the government can't give medical examiners the same salary as fellow doctors because other civil servants would find it unfair, it should hire them as grade IV chief specialists given their ability and experience."

BY LEE YOUNG-KEUN [kim.jiye@joongang.co.kr]