South Korea medical standoff intensifies

Medical professors from Gyeongsang National University in South Korea have resigned, and many from several other universities said they would follow suit. The mass resignations are part of the medical community’s wider protest against the government’s plan to raise the yearly medical school admission caps by 2,000 from the current 3,058. More than 11,000 interns and residents at 100 hospitals have walked off their jobs in a strike that has continued for over two weeks.

The walkout shows no sign of stopping as the government forges ahead with the quota hike set to take effect next year.

Officials say the measure is necessary to alleviate the shortage of doctors in a country that is rapidly aging. But medical professionals critical of the reform say the increase alone will not guarantee more doctors for the specializations that really need them, such as emergency medicine and pediatrics. They worry the abrupt admission spike would undermine the quality of medical education and question adding that many doctors when the population is decreasing.

South Korea has 2.6 doctors per 1,000 people, according to the latest data from the Organization for Economic Cooperation and Development. The doctor-to-patient ratio is among the lowest for developed countries. The United States has 2.7 doctors per 1,000 people.

In a nation with about 140,000 doctors, the striking trainee physicians account for up to 40 percent of total doctors at certain major hospitals. Patients are caught in the middle of the dispute as understaffed hospitals have turned some of them away and canceled surgeries. To help fill the gap, military hospitals have eased entry procedures for civilians seeking treatment at their emergency rooms. The government has also authorized nurses to perform some medical procedures previously reserved for doctors.

Strikers defied the government’s deadline for them to return to work by Feb. 29, despite warnings that they would face license suspension and criminal charges. Others in the medical community are also not backing down. Faculty councils from 33 medical schools filed an administrative lawsuit against the Health Ministry and an injunction against the planned admission increase. The Korean Medical Association said about 40,000 people opposing the reform participated in a rally in Seoul on Sunday, while police put the number around 9,000.

The government has begun to clamp down on the protest. Authorities have initiated the process to suspend the licenses of about 7,000 striking junior doctors for at least three months. In addition, the Health Ministry filed charges against five current and former KMA officials, accusing them of instigating the walkout and violating medical laws.

But taking legal actions against the residents on strike will only exacerbate the shortage of doctors in the long run, said Hojoon Sohn, associate professor of preventive medicine at Seoul National University. It will “certainly not help with the government’s aim to strengthen essential medical services and reduce regional disparities in our healthcare system,” said Sohn.

While rural areas lack physicians, South Korea’s national health insurance system has contributed to the shortage in certain specializations. Under that system, hospitals charge patients fees the government sets for medical care it considers essential. But some physicians say the fixed fees are often insufficient to cover costs. That would disincentivize some doctors from entering essential but lower-paying fields like emergency medicine and pediatrics, when they can specialize in dermatology or cosmetic surgery, fields that allow them to charge more money for uninsured procedures.

Sohn pointed out that the effectiveness of the admission increase will depend on multiple variables. They include how medical schools implement the admission process, how they accommodate the influx of students, and whether there are ways to ensure future doctors choose the disciplines that society needs most.

In the meantime, “the government and striking doctors need to return to the negotiating table and strategize what’s best for patients,” he said, noting that the longer the dispute lasts, the harder it will be to reach adequate solutions.