Seeking to resolve a looming doctor shortage, the South Korean government introduced a policy aimed at significantly increasing the number of medical professionals in the country. However, this initiative ignited an unprecedented backlash, resulting in a large-scale Korean Doctor Strike that has thrown the nation’s healthcare system into turmoil.
On February 20, 2024, junior doctors initiated a major walkout, marking a critical moment in South Korea’s healthcare landscape. This drastic action was a direct response to the government’s publicized strategy to augment annual medical school admissions by 2,000 students for the next decade. Now, several months into this impasse, a resolution remains elusive, leaving both the medical community and the government entrenched in a protracted standoff.
…Korea’s community of medical students and junior doctors does not believe increasing the number of medical students will address the core challenges within the nation’s healthcare system.
The government’s proposition to elevate medical school enrollment is rooted in the pressing concern of a perceived scarcity of doctors, a problem exacerbated by South Korea’s rapidly aging population. Data from the Organization for Economic Cooperation and Development (OECD) reveals that South Korea has approximately 2.6 doctors per 1,000 individuals, placing it among the lowest ratios within developed nations. This statistical reality underscores the government’s urgency to bolster the ranks of medical practitioners.
However, the perspective within South Korea’s medical student and junior doctor community diverges sharply. They contend that merely increasing the quantity of medical students fails to tackle the fundamental deficiencies within the nation’s healthcare framework. Their arguments are multifaceted and point to deeper systemic issues. Firstly, they highlight the maldistribution of doctors across geographical regions and specializations. Secondly, they draw attention to the adverse working conditions endured by doctors in essential fields, characterized by extended work hours and inconsistent remuneration. Junior doctors in South Korea frequently face grueling 36-hour shifts, a stark contrast to the 24-hour shifts more common in countries like the United States. Thirdly, Korean doctors are exposed to substantial litigation risks; statistics indicate that one in three doctors have encountered a malpractice lawsuit since 2019.
Adding complexity to the situation is the evident inclination of many doctors to pursue more financially rewarding and less stressful specialties such as dermatology and cosmetic medicine. This trend leaves critical areas like pediatrics, obstetrics, and emergency medicine chronically understaffed and overburdened, further straining the healthcare system’s capacity to cope with national needs.
The Protracted Standoff and Attempts at Resolution
Despite the unwavering protests from the medical fraternity, the government has maintained its course regarding the policy adjustments. It’s noteworthy that a comparable strike action unfolded in 2020 when a similar increase in medical school admissions was proposed. At that time, amidst the burgeoning COVID-19 crisis, the government ultimately rescinded its plan. Until the current year, the medical school quota had remained unchanged since 1998. Nevertheless, a revised quota increase, setting the figure at 1,509 additional slots for the 2025 academic year, was officially endorsed by the Korean Council for University Education in May, signaling the government’s firm stance.
In response to this finalized quota increase, over 12,000 junior doctors have engaged in job action, relinquishing their posts. Adding weight to the movement, medical professors have also joined the strike in a show of solidarity. Reports suggest that over 95% of medical students slated to graduate in 2025 are refusing to sit for their licensing examinations, potentially creating a future bottleneck in the medical pipeline.
The South Korean Ministry of Health has explored various avenues to persuade doctors to cease their strike and return to work. Initially, the government issued a return-to-work directive in February and issued threats to suspend the licenses of non-compliant doctors. However, by June, the government adopted a more conciliatory approach, aiming to incentivize striking doctors to resume their duties. The threatened license suspensions were put on hold, and new guidelines were introduced to facilitate medical students’ reintegration into their educational paths. Subsequently, the government appealed to hospitals to process resignations, a move interpreted as a dual strategy to either encourage doctors back to work or enable them to seek positions in alternative healthcare facilities.
Currently, the impact of the strike is profound, with only approximately 8% of junior doctors remaining on duty across the 211 general hospitals nationwide. This drastic reduction in workforce has placed immense pressure on the remaining medical staff and significantly diminished the capacity of hospitals to deliver timely and comprehensive care.
Counterproductive Outcomes and Systemic Risks
The ongoing standoff has had a palpable impact, with patients seemingly bearing the brunt of the korean doctor strike. Widespread frustration is mounting among the public due to challenges in accessing emergency medical services and the indefinite postponement of scheduled surgeries and treatments. Emergency rooms are reportedly operating at minimal capacity, and numerous individuals are compelled to travel considerable distances to secure emergency care, highlighting the strain on the system.
Public sentiment appears divided, with a general consensus urging both the striking doctors and the government to find common ground and resolve the impasse. President Yoon Suk-yeol’s approval ratings experienced a significant drop, plummeting to a record low of 21% in June, following his party’s electoral setback in the National Assembly elections in April, suggesting public dissatisfaction with the handling of the situation.
With a substantial number of junior doctors still off the job and the healthcare system operating under duress, the prospects for integrating new trainee doctors into hospitals nationwide appear bleak. The government is actively exploring alternative strategies to mitigate the crisis, including designating specific major hospitals to handle critically ill patients, aiming to redistribute resources and expertise. Another measure implemented to alleviate the burden on the healthcare system is the enactment of new legislation in August, expanding legal protections for nurses and empowering them to undertake tasks previously under the purview of junior doctors. This legislative change reflects an attempt to optimize the existing healthcare workforce amidst the doctor shortage. This korean doctor strike unfolds against a backdrop of global unrest within medical communities, including similar protests for improved working conditions witnessed in India and Germany this year, indicating a broader pattern of physician advocacy for better healthcare environments.
The government’s sense of urgency is amplified by the demographic projections indicating that South Korea is on the cusp of becoming a ‘super-aged’ society, with estimations suggesting that senior citizens will constitute 30% of the population by 2035. Furthermore, South Korea is projected to become the world’s oldest nation by 2044. This demographic shift towards an aging population underscores the anticipated surge in demand for complex medical care, heightening concerns about the adequacy of the doctor supply in the long term.
In conclusion, while the korean doctor strike continues without a clear end in sight, the government’s initial policy proposal to augment medical school admissions appears to have inadvertently triggered counterproductive consequences. The underlying systemic issues within the Korean healthcare system demand comprehensive attention and reform. However, meaningful progress remains challenging as long as the doctor workforce remains strained and the core grievances of the medical community are unresolved, leaving the future trajectory of South Korea’s healthcare system uncertain.
