The views of the government and the medical society have conflicted for many years on policies influencing the medical sector, but never before have the conflicts escalated to such a mass walkout by doctors. Reports of the unfolding events may imply that the opposition to the “Essential Healthcare Policy Package” is simply due to doctors-in-training becoming anxious of the potential reduction of job opportunities or income. However, doctors have put forward claims that go far beyond the surface: the new policy does little to mend the fundamental flaws of the current medical system in Korea. 

The Yoon administration’s rationale behind the policy is to improve access to and quality of medical care amidst a quickly aging population, addressing a shortage of doctors in essential specializations and rural areas. The main point of contention has been the increase in medical school admission quotas. The government announced that 2,000 more students are to be accepted into medical schools every year until 2035, a stark 65% increase from the current quota of 3,058 admits per year. Many are pessimistic on whether the quality of education will be able to hold up with such an increase, especially in terms of practical training. Furthermore, the Korean Medical Association, along with many doctors, are skeptical on whether the policy will effectively narrow down disparities between specialties and regions. The proposal is ultimately counting on a “trickle-down effect” in which the number of doctors pursuing essential divisions or working in non-metropolitan areas will increase due to the increased total. High-paying professions with a work-life balance such as ophthalmology, plastic surgery, and dermatology clearly attract doctors; thus, an appropriate distribution of doctors would be impossible without improving compensation, no matter how many more are admitted to medical school. Considering the fact that Korea is one of the countries where medical care can be received without much delay, those in the field call for improvements to working conditions and pay instead of a seemingly impractical policy.

Other measures, such as introducing a license to open personal clinics or limiting the mixing of treatment methods that are reimbursed and unreimbursed by the national health insurance in one examination, have also gained objection. In particular, the latter is remarked to be a proposal that lacks understanding of the reality of healthcare; it limits options for patients and reduces the income of doctors, which may in turn affect the quality of healthcare.

All in all, the current situation may be natural considering the characteristics of the Korean society and its healthcare system. More than 90% of hospitals are privately owned, unlike many other countries in the world; thus, the system is focused on a low-cost, high-profit structure that depends on the efficiency of doctors. The medical crisis results from the intern or resident doctors on strike, who take up 40% of all doctors in university hospitals and regularly work far past the legal limit of 52 hours per week (around 77.7 hours according to the Korean Intern Resident Association) despite their “in training” status. Some patients look for better, more famous hospitals even if their symptoms are not severe, increasing the workload for tertiary general hospitals in comparison to lower-level clinics. Part of the reason so many of Korea’s top students aim to go to medical schools is, inevitably, the stability and profitability of the job, which explains the discrepancy between popular and unpopular positions within the medical community. Over the years, the state has not done much to alleviate the aforementioned issues, and perhaps in the current context of policy making, there is a need to understand and incorporate the fact that doctors — though dedicated to their patients — are also workers with needs to be addressed.

Nevertheless, the government attempts to suppress the mass action through legally binding back-to-work orders and threats of canceling medical licenses. Administrative procedures have now been initiated, and licenses of doctors-in-training who have not yet returned are to be suspended for three months or more. However, these forced measures only seem to be worsening the medical void and heightening the aversion to returning. 6,051 medical school students have taken a leave of absence. Many professors have stood in solidarity with their students, with the Medical Professors Association of Korea holding an emergency general meeting to discuss resignation as of March 14. Doctors’ organizations such as the World Medical Association have expressed their support. It appears unlikely that any similar government response will have positive implications in the long term.

The need for a structural reform is what both the government and the medical society concur upon. However, their views on the necessary steps to achieve that reform seem almost impossible to align. With the government resolute on maintaining its policy package despite strong retaliation, it is clear that there has not been enough consultation with those actually working in the field. The walkout is an expression of not just one opinion, but thousands of like-minded people. It seems that it is time to look for a compromise, however big or small it may be.