Why are South Korea's trainee doctors resigning en masse?

Trainee doctors in South Korea are resigning in droves.

Monday witnessed surgeries and other procedures at the country’s five largest hospitals being delayed after en masse resignations from trainee doctors — though the country’s healthcare system remains unscathed thus far.

This comes after the Korea Intern Resident Association in an emergency meeting last week decided to take collective action.

But what do we know about the walkout? And why are trainee doctors striking?

Let’s take a closer look:

What do we know?

According to Time Magazine,  Park Dan, head of the Korea Intern Resident Association on Facebook on Friday, warned that doctors at major institutions such as Seoul National University Hospital would submit their resignation letters on Monday and walk off work on Tuesday.

As many as 2,700 trainees, who comprise just over a third of doctors at hospitals, could walk out.

There are fears that the strike could widen and over 12,000 senior doctors could also join in.

At the heart of the story is the number of admissions to medical schools.

While around 3,000 students enter medical school every year, the government of President Yoon Suk Yeol wants to raise that number to around 5,000 from 2025.

As per Time Magazine, the cap has remained steady since 2006.

The government has a sound reason for this.

Though South Korea has about 140,000 professional doctors, the government points out that of all developed nations, South Korea has among the fewest doctors relative to size of the populace.

Time Magazine quoted data from the Organisation for Economic Co-operation and Development as showing that the country has just 2.6 doctors per 1,000 people.

Greece, by comparison, has 6.3 doctors per 1,000 people.

By 2035, South Korea is projected to face a shortfall of 15,000 doctors.

The government wants to add 10,000 doctors  to the rolls by that year.

South Korea also has one of the world’s lowest birth rates and has been grappling with shortages of doctors in some key professions, including obstetrics and paediatrics, and in rural regions outside the greater capital area.

The plan also aims to ensure there are enough doctors practising outside large cities and expand legal protection for the profession against malpractice suits and prosecution.

Seoul’s Asan Medical Center said that a number of interns and resident doctors there submitted resignation letters and that it was trying to reschedule planned surgeries and other medical treatments for some patients.

Seoul’s Severance Hospital said some of its trainee doctors also handed in resignation letters and suggested it could rearrange surgery schedules as well.

South Korean media reported that hundreds of trainee doctors at other hospitals have already submitted their resignation letters.

Media reports say some hospitals have canceled or put off planned cancer surgeries, child births and other procedures in which trainee doctors assist senior doctors during surgeries.

The Health Ministry said it was trying to find how many of the total trainee doctors at the five hospitals — estimated at about 2,700 in local media — submitted their resignations.

What do doctors’ groups say?

But doctors’ groups argue that there are other more pressing issues to deal with — like raising medical fees for example.

Others claim the number of doctors going up dramatically could result in doctors having to compete with each other, give rise to unnecessary medical treatments and burden to the public health insurance.

They also say the plan will not address the overburdening of large teaching hospitals and a lack of incentives for doctors to practice in essential healthcare services such as paediatrics, obstetrics and emergency medicine.

The Korea Medical Association, which represents doctors, said it plans to hold rallies in support of the trainee doctors but hasn’t determined whether to join their walkouts.

“If the government wants doctors to work for the crucial sectors like obstetrics or paediatrics, they should build legal safety net and increase medical fee first so that the doctors in those sectors wouldn’t feel pressured to be sued over accidents or be burdened by heavy workloads,” said Joo Sooho, former president of Korea Medical Association.

Doctors have successfully resisted several government attempts to increase the number of students in past years, including during the COVID-19 pandemic.

Critics say doctors are mainly concerned the reform could erode their salaries and social status.

What is the government saying?

Vice Health Minister Park Min-soo expressed “deep worries and regrets” over the trainee doctors’ action.

Park, citing a medical law, said the government ordered them to continue their jobs.

Under South Korean medical laws, doctors, who are considered essential workers, are forbidden from undertaking mass work stoppages.

There’s also a political angle to consider.

The development comes as parliamentary elections are slated to be held in April.

Time Magazine quoted a poll showing the public is in favour of the government’s plan.

The Gallup Korea poll on Friday showed 76 per cent of respondents approving, while just 16 per cent did not.

Yoon’s personal approval also has increased from 29 per cent two weeks ago to 33 per cent.

In an editorial published Thursday, the Korea JoongAng Daily newspaper said a strike by doctors would attract little public support.

Earlier Monday, Prime Minister Han Duck-soo said the government will take steps to prevent the trainee doctors’ action from undermining the care of emergency patients.

He said that more than 400 emergency medical treatment centers across South Korea will stay o.pen around the clock.

He said the government will deploy military doctors if the situation worsens.

Han on Sunday had pleaded ith doctors not to take people’s lives hostage.

Han said if doctors leave their jobs or take actions that cause a vacuum in healthcare, the damage will fall on the public.

“This is something that takes the lives and health of the people hostage and must not happen,” Han said in a statement, referring to the planned mass resignation of trainee doctors.

While the government plans to meet with doctors’ groups to address their concerns, it has no intentions to adjust the scale and timing of the medical student increase, Second Vice Health Minister Park Min-soo said during a briefing Thursday.

“I implore trainee doctors to not turn their backs on patients,” he said, adding the government would be inspecting hospitals to check whether doctors had joined the strike.

The police warned they could arrest “key instigators” of the work stoppages.

Park said the plan was necessary in South Korea’s fast-ageing society, with doctors set to be “overwhelmed with exponential demand” down the road if the current quota remained.

“Hospitals are already having hard time finding doctors now, and problems of accessing medical service in time have occurred repeatedly,” Park added.

The health ministry said 715 trainee doctors have submitted their resignation as of Friday.

It has issued a back-to-work order, warning that refusing to comply will result in punishment.

The Korean Medical Association slammed the government.

It called the government’s threats of legal action were akin to a “witch hunt” and  claiming the plan would create a “Cuban-style socialist medical system”.

With inputs from agencies