Efforts needed to maintain and develop essential medical services in the neurosurgery field

Background: Although it is naturally included in essential medical services (EMS), neurosurgery is not included in the current EMS set by the Ministry of Health and Welfare of South Korea. Therefore, as of 2023, I would like to describe the causes and current status of the progressively decreasing number of brain surgeons, which are responsible for an important axis of EMS, and the efforts needed to maintain and develop EMS.Current Concepts: The resident application rate for neurosurgery has not deviated much from 80 to 120 annually over the past 20 years; therefore, it does not seem to be included in the so-called “dying EMS.” However, the number of individuals who withdraw during the 4-year resident training period is as high as 15.43%, and the number of new neurosurgery specialists after resident training decreases gradually. The number of brain surgeons is declining, as many neurosurgeons specialize in the spine rather than the brain. Moreover, the extremely low cost of neurosurgery compared to that of Organization for Economic Co-operation and Development countries and cruel reality of Korea sets brain surgeons in a dangerous situation.Discussion and Conclusion: To save essential medical neurosurgeons, especially brain specialists, it is extremely necessary to make the medical fee realistic, improve the status of neurosurgeons, and improve the excessive criminal punishment for medical accidents that occur during treatment and surgery. There is no future for Korean neurosurgery without proper compensation for neurosurgeons who work with many dangerous surgeries and shorten the lifespan of doctors.