Pediatric anesthesiologist shortage in South Korea: a nationwide survey of workforce and training

Pediatric anesthesia is a specialized field that requires dedicated training and expertise. Although global workforce surveys have documented substantial disparities in anesthesia provider density, data on the pediatric anesthesia workforce in South Korea remain limited. This study aimed to provide the first comprehensive assessment of the pediatric anesthesia workforce and training landscape in South Korea. A nationwide cross-sectional survey was conducted by the Korean Society of Pediatric Anesthesiologists (KSPA) between February 26 and March 21, 2025 via email to all 235 contactable KSPA members. The survey assessed demographic characteristics, practice patterns, training background, workforce challenges, and educational needs. Respondents were categorized as weekly practitioners (performing pediatric anesthesia or sedation at least once per week) or non-weekly practitioners (less than once per week). Data were analyzed using descriptive statistics, with a multivariable logistic regression of factors associated with weekly practice. Of the 235 members, 159 (68%) responded, with no significant difference from the full membership in age or region. Ninety-two (58%) were weekly practitioners and 67 (42%) non-weekly; only 15% reported pediatric anesthesia as their primary area of practice. Most weekly practitioners (84%) worked at university hospitals, and 52% practiced in Seoul. Two-thirds reported that their institution lacked a dedicated pediatric anesthesiologist, and 98% received no additional compensation for pediatric anesthesia. Over two-thirds (68%) reported workforce-related difficulties, and among non-weekly practitioners, 64% reported no intention to return to pediatric practice. In multivariable analysis, university-hospital affiliation was the only factor independently associated with weekly practice (adjusted OR 2.34, 95% CI 1.07–5.14); fellowship training and practice in Seoul were not. This nationwide survey describes a small pediatric anesthesia workforce that is geographically concentrated and, in most institutions, without dedicated subspecialty support. The concerns most frequently reported by practitioners — medicolegal exposure, absence of additional compensation, and limited training opportunities — represent priorities that warrant attention in workforce policy.