Surgeries were postponed. Appointments cancelled. The patients were removed from the emergency room.
For more than a week, procedures at some of South Korea’s biggest hospitals have been halted as thousands of interns and residents walked off the job. A prolonged strike could have disastrous consequences.
The controversy began in early February when the government proposed admitting more students to medical schools to address South Korea’s long-standing shortage of doctors. Interns and residents, known as physician interns, responded by saying the shortage was not industry-wide, but limited to specific specialties such as urgent care. They said the government’s plan would not solve this problem, adding that they were victims of a system full of harsh working conditions and low wages.
Doctors then took to the streets to protest the plan, threatening to strike or walk off the job. In general, senior doctors supported the claims of their younger colleagues. But with surveys showing broad public support for boosting the ranks of doctors, the government has not backed down. Some saw pushing doctors away as a tactic to increase their salaries.
Medical interns — a critical part of major hospitals — began submitting their resignations on February 19. As of Wednesday, nearly 10,000, or about 10 percent of all doctors in the country, had done so, according to government figures. But most of these resignations were not accepted by the hospitals.
“It is impossible to justify collective action that holds people’s health hostage and threatens their lives and safety,” President Yoon Suk-yeol told reporters on Tuesday.
His government has said that if doctors return to work by Thursday, they will face no legal repercussions. Otherwise, they risk losing their medical licenses and face fines of up to 30 million won ($22,000). The Ministry of Health this week filed police complaints against some doctors, accusing them of violating medical law.
As of Thursday morning, nearly 300 doctors have returned to work, according to the ministry. But with most practicing doctors still out of work, the dispute shows no sign of resolution.
Here’s what you need to know.
What is the situation now in hospitals?
Many medical procedures have been pushed back. Patients have been told at the last minute that their appointments have been delayed indefinitely. Some have been redirected to smaller clinics. The government has temporarily allowed hospitals to allow nurses to fill in for doctors when needed. However, many large hospitals remain understaffed, prompting complaints from the public.
One case this week was used by both sides to bolster their arguments. A woman in her 80s with terminal cancer was turned away from several emergency rooms after her heart stopped beating, with hospitals saying she was able to. When she was finally brought in, she was pronounced dead on arrival.
For the government and its supporters, it showed how a shortage of doctors could be fatal for patients – even though a government inquiry concluded that the woman’s death had nothing to do with the doctors leaving.
For doctors, it was the clearest indication of a structural problem that has long overburdened emergency care in South Korea. The country’s medical system allows patients with minor injuries or illnesses to seek treatment in emergency rooms, using resources that should instead go to patients in serious or critical condition, doctors claim.
What has the government proposed?
The need for more doctors in South Korea is dire, the government says, especially given its rapidly aging population. It has about 2.6 doctors for every 1,000 people, compared to an average of 3.7 for countries belonging to the Organization for Economic Co-operation and Development.
Earlier this month, the health ministry proposed increasing medical school admissions to about 5,000 students a year, up from 3,000, starting in 2025. It would be the first increase since 2006 and, the government said, would mean an extra 10,000 doctors in a decade. The government also pledged to spend more than 10 trillion won to improve basic services across the country, especially health care in rural areas.
Doctors argue that increasing the number of medical students will not change the status quo much. A similar attempt by Mr. Yoon’s predecessor in 2020 to increase the number of doctors led to a month-long doctor walkout. The government ended up shelving the expansion.
What do doctors want?
Practitioners and residents have a long list of complaints. While some established doctors in South Korea are well paid, trainee doctors say they work long hours for little pay, despite being the linchpins of the country’s medical system. Interns and residents earn about $3,000 a month and often work more than 80 hours a week, according to the medical community. Young doctors often make up a third or more of the workforce at some of the major hospitals and often provide the front line of care for patients.
They say the government has ignored structural issues that make certain specialties such as cosmetic surgery and dermatology more lucrative than vital services such as emergency and paediatrics. The Korean Medical Association and the Korean Intern and Resident Association, two of the country’s largest doctors’ groups, have called for better working conditions for young doctors in basic services, more equal pay across specialties and the withdrawal of the expanded medical admissions threshold. schools.
Under the current conditions, it is “impossible for doctors to care for patients with a sense of mission,” Joo Soo-ho, a spokesman for the Korean Medical Association, said on Tuesday.
Is there a political element to the controversy?
The plan to increase the number of medical students enjoys widespread support among South Koreans, according to surveys. In one, 76% of respondents supported the government’s plan.
The proposal to increase medical school enrollment is part of a broader health care policy plan announced by President Yun months before crucial parliamentary elections in April. His approval rating has risen as he has stood his ground against doctors.
For most of his two years in office, Mr. Yun has struggled with low approval ratings, rising consumer prices and scandals linked to his wife, his policies and his handling of disasters. Pushing through changes that his predecessor had tried but failed to implement in the face of resistance from doctors, Mr Yun hopes to raise his profile in an election year.
Choe Sang-Hun contributed to the report.
