South Korea’s ambitious plan to tackle its doctor shortage by increasing medical school admissions has backfired, triggering a massive strike by physicians and plunging the nation’s healthcare system into turmoil. On February 20, 2024, junior doctors initiated a significant walkout, a move that sent shockwaves through South Korea’s medical infrastructure. This drastic action was in direct response to the government’s proposal to augment medical school enrollment by 2,000 students annually over the next decade. Months later, the impasse between the medical community and the government persists, leaving the nation grappling with a prolonged healthcare crisis.
…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 rationale for expanding medical school admissions stemmed from a pressing need to address the escalating shortage of doctors, particularly as South Korea confronts a rapidly aging population. Data from the Organization for Economic Cooperation and Development (OECD) reveals that South Korea has a mere 2.6 doctors per 1,000 individuals, placing it among the lowest ratios in the developed world. This scarcity is further exacerbated in smaller towns and rural areas, where access to medical professionals is even more limited.
However, South Korean medical students and junior doctors contend that simply increasing the number of medical school graduates will not resolve the fundamental issues plaguing the healthcare system. 1 Their primary arguments highlight systemic problems that extend beyond mere numbers. Firstly, they point to the uneven distribution of doctors across the country, with a concentration in urban centers and a lack of medical professionals in rural areas. This geographical maldistribution is compounded by a specialization imbalance, with shortages in essential fields. Secondly, doctors, particularly those in critical and essential fields, face grueling working conditions characterized by excessively long hours and inadequate compensation relative to the demands and responsibilities. Junior doctors in South Korea routinely endure 36-hour shifts, a stark contrast to the 24-hour shifts more common in countries like the United States. Finally, South Korean doctors are exposed to high litigation risks, with statistics indicating that approximately one in three doctors has faced a malpractice lawsuit since 2019.
Adding to the complexity, many doctors are choosing to specialize in more lucrative and less demanding fields such as dermatology and cosmetic medicine. This trend further depletes the ranks of physicians in crucial but less attractive specialties like pediatrics, obstetrics, and emergency medicine, leaving these essential areas critically understaffed and overburdened. The preference for certain specialties exacerbates the existing shortages in vital medical fields, creating a precarious situation for the nation’s overall healthcare infrastructure.
Stalemate in Negotiations Deepens Healthcare Crisis
Despite the persistent and vocal protests from the medical community, the South Korean government has remained steadfast in its commitment to increasing medical school admissions. This is not the first time such a proposal has ignited medical professionals’ ire; a similar plan in 2020 also triggered strikes. However, in the face of the burgeoning COVID-19 crisis at that time, the government ultimately retracted its proposal. Prior to the current policy change, the medical school quota had remained unchanged since 1998, highlighting the long-standing inflexibility in medical education policy. In May, the Korean Council for University Education finalized a revised quota increase of 1,509 for the 2025 academic year, signaling the government’s determination to move forward despite ongoing opposition.
In response to the finalized quota increase, over 12,000 junior doctors have engaged in job action, exacerbating the strain on hospitals nationwide. Medical professors have also joined the strike in solidarity, further amplifying the disruption. Compounding the crisis, reports indicate that over 95% of medical students slated to graduate in 2025 are refusing to take the crucial licensing exam, raising concerns about the future pipeline of medical professionals.
The South Korean Ministry of Health has attempted various measures to persuade striking doctors to return to work. Initially, the government issued a return-to-work order in February, accompanied by threats to suspend the licenses of doctors who defied the deadline. However, by June, the government adopted a more conciliatory approach, seeking to incentivize striking doctors to resume their duties. The threat of license suspension was withdrawn, and new guidelines were introduced to facilitate medical students’ return to their education. Subsequently, the government urged hospitals to process resignations, a move intended to either encourage doctors to return to work or enable them to seek employment at alternative medical facilities.
Currently, a mere 8% of junior doctors are staffing the 211 general hospitals across South Korea, leaving the healthcare system severely compromised and struggling to meet the needs of the population. The reduced workforce is placing immense pressure on remaining medical staff and significantly impacting patient care.
Counterproductive Outcomes and Public Fallout
The ongoing standoff is having a palpable and detrimental impact on patients, who are increasingly bearing the brunt of the doctors’ strike. Patients are expressing growing frustration due to difficulties in accessing emergency care and experiencing indefinite postponements of scheduled surgeries and treatments. Emergency rooms across the country are reportedly operating at drastically reduced capacity, and many individuals are forced to travel considerable distances to receive urgent medical attention.
Public sentiment is increasingly critical of both sides in the dispute, with widespread calls for a swift resolution to the impasse. The political ramifications are also evident, with President Yoon Suk-yeol’s approval rating plummeting to a record low of 21% in June, following his party’s defeat in the National Assembly elections in April. The public discontent reflects the growing anxiety and disruption caused by the prolonged healthcare crisis.
With the majority of junior doctors on strike and the healthcare system under immense strain, the prospects for replenishing the ranks of trainee doctors in hospitals appear bleak. The government is actively pursuing alternative measures to mitigate the crisis, including designating major hospitals to focus on treating critically ill patients. Another significant action to alleviate pressure on the healthcare system is the recent passage of legislation in August that expands legal protection for nurses, empowering them to undertake tasks previously performed exclusively by junior doctors. This legislative change reflects an attempt to redistribute responsibilities and optimize the utilization of available medical personnel. The South Korean doctors’ strike is unfolding against a backdrop of broader international unrest within medical communities, including recent protests in India and Germany advocating for improved working conditions, indicating a global trend of physician dissatisfaction.
The government’s urgency to resolve the doctor shortage is underscored by the projection that South Korea is rapidly approaching becoming a ‘super-aged’ society, with an estimated 30% of the population comprised of senior citizens by 2035. Furthermore, South Korea is projected to become the oldest nation globally by 2044. This demographic shift will inevitably lead to a surge in demand for complex medical care, amplifying concerns about the adequacy of the doctor supply.
While the South Korean doctors’ strike shows no immediate signs of abating, the government’s initial proposal to increase medical school admissions appears to have yielded counterproductive outcomes. Addressing the deeper, systemic issues within the Korean healthcare system is crucial for a sustainable solution, but progress remains elusive while the doctor shortage persists and the strike continues to disrupt medical services.
The views expressed are the author’s alone, and do not represent the views of the U.S. Government or the Wilson Center. Copyright 2024, Indo-Pacific Program. All rights reserved.
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