What you need to know about the doctors’ protests in South Korea

Operations postponed. Appointments cancelled. Patients turned away from the emergency room.

For more than a week, procedures have been disrupted at some of South Korea’s largest hospitals as thousands of medical interns and residents have quit their jobs. A prolonged strike can have disastrous consequences.

The dispute began in early February, when the government proposed admitting more students to medical schools to address South Korea’s long-standing doctor shortage. Interns and residents, also known as doctors in training, responded by saying that the shortage did not apply to the entire sector, but was limited to certain specialties, such as emergency medicine. They said the government’s plan would not solve that problem, adding that they were victims of a system full of harsh working conditions and low wages.

The doctors then took to the streets to protest the plan, threatening to strike or leave their jobs. In general, senior doctors supported the claims of their younger colleagues. But surveys showed there was broad public support for strengthening the ranks of doctors, and the government didn’t back down. Some saw pushing back the doctors as a tactic to increase their pay.

Trainee doctors – who are a crucial part of major hospitals – started 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 data. But most of these layoffs have not been accepted by 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 on Thursday, they will face no legal consequences. Otherwise, they risk losing their medical licenses and face fines of up to 30 million won ($22,000). The Health Ministry this week filed police complaints against a handful of doctors, accusing them of violating the medical law.

According to the ministry, almost 300 doctors were back at work on Thursday morning. But with most trainee doctors still out of work, the dispute shows no signs of resolution.

Here’s what you need to know.

What is the situation in hospitals now?

Many medical procedures have been postponed. Patients have been told at the last minute that their appointments have been postponed indefinitely. Some have been referred to smaller clinics. The government has temporarily allowed hospitals to allow nurses to take the place of doctors when necessary. Nevertheless, many major hospitals are still short-staffed, leading to complaints from the public.

One case this week was used by both sides to strengthen their argument. A woman in her 80s with terminal cancer was sent away from several emergency rooms after her heart stopped beating. Hospitals said they had excess capacity. When she was finally admitted, she was pronounced dead on arrival.

For the government and its supporters, it showed how a shortage of doctors can be fatal for patients — even as a government investigation concluded the woman’s death was not related to the doctor shortage.

For the doctors, this was the clearest sign of a structural problem that has long overloaded emergency rooms in South Korea. The country’s medical system is allowing 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 acute, the government says, especially given its rapidly aging population. The country has approximately 2.6 doctors per 1,000 inhabitants an average of 3.7 in the countries belonging to the Organization for Economic Co-operation and Development.

Earlier this month, the Health Ministry proposed increasing the number of medical schools from 3,000 to around 5,000 students per year, starting in 2025. It would be the first increase since 2006 and, the government said, an additional 10,000 doctors in ten years time. The government also pledged to spend more than 10 trillion won to improve essential services across the country, especially healthcare in rural areas.

Doctors argue that increasing the number of medical students will do little to change the status quo. A similar attempt by Mr Yoon’s predecessor in 2020 to increase the number of doctors resulted in a month-long doctors’ strike. The government eventually suspended the expansion.

What do the doctors want?

Interns 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, even though they are at the heart of the country’s medical system. According to the medical community, interns and residents earn approximately $3,000 per month and often work more than 80 hours per week. Young physicians often make up a third or more of the workforce in some large hospitals and often provide primary care for patients.

They say the government has ignored structural problems that make some specialties such as cosmetic surgery and dermatology more lucrative than vital services such as emergency medicine and paediatrics. The Korean Medical Association and the Korean Intern and Resident Association, two of the country’s largest physician groups, have demanded better working conditions for young doctors in essential services, more equal pay across all specialties and the repeal of the expanded medical school admissions cap.

Under the current circumstances, 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 dispute?

The plan to increase the number of medical students is popular broad support among South Koreans, studies show. In aas many as 76 percent of respondents supported the government’s plan.

The proposal to increase admissions to medical schools is part of a broader healthcare policy plan announced by President Yoon months ahead of crucial April parliamentary elections. His approval rating has centimeter up as he stood his ground against the doctors.

For most of his two years in office, Mr. Yoon has struggled with low approval ratings, rising consumer prices and scandals linked to his wife, his policies and his handling of disasters. By implementing changes that his predecessor tried but failed to implement despite physician resistance, Mr. Yoon to improve his profile in an election year.

Choe Sang Hun reporting contributed.