Surgery and surgeons in Korea are currently facing a very serious dilemma even though modern surgical practices have a great impact on the improvement of health care and human well being. Traditionally, in Korea, surgical practice had been attractive as a profession and many young medical students were eager to become surgeons. Ever since the National Health Insurance policy was adopted to the whole of the population and the Insurance payment to medical professionals, especially surgeons, were below normal, private surgical practitioners are suffering low incomes. Eventually this situation was affected surgical house staff. The quality and quantity applying for surgical residency have markedly decreased and the situation is getting worse year by year. This review addresses whole possible causes of the present situation; status of surgical practices, educational problems in residency, duty stresses of young surgeons and the life style of the younger generation. Working hour restrictions in Europe and America were reviewed and an example of the Chonnam National University Hospital was elucidated. Possible solutions were suggested in terms of the training hospitals and their staff, the Korean Surgical Society and the policy makers.