2024 South Korean doctors' strike

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2024 South Korean doctors' strike
DateFebruary 20, 2024 (2024-02-20) - present
(2 months, 1 week and 2 days)
Location
 South Korea
Caused by
  • Dissatisfaction over planned increase of medical students enrolment
  • Imbalance of medical services
GoalsWithdrawal of the plan to increase medical students enrolment
MethodsStrike action, demonstration, resignation
StatusIn progress
Parties

Korean medical community

List
Casualties and losses
Deaths: 1

The 2024 South Korean doctors' strike is an ongoing strike in South Korea which began on February 20, 2024 when doctors in South Korea expressed dissatisfaction with the announcement of new government policies on significantly increasing the medical student quotas going forward. Thousands of doctors have since resigned or refused to work, which has resulted in patients being unable to receive timely treatment at the hospitals,[1] with at least one death attributed to the labor action.[2]

Background and causes[edit]

According to the Korea Intern Resident Association, intern and resident doctors in South Korea work 36-hour shifts, in comparison to the United States where they work less than 24 hours. About half of these doctors would work no more than 60 hours per week on average in United States, while in South Korea it is common to exceed more than 100 hours per week.[3]

Korea Medical Association believes that the root cause of the shortage in South Korea's medical services is not the lack of doctors, but the uneven distribution of medical facilities between urban and rural areas, poor labor conditions, and high litigation risks. Therefore, they believe that increasing the number of doctors will not resolve the shortage.[4]

According to South Korean President Yoon Suk Yeol, the basic medical system is collapsing with many disciplines such as pediatrics, obstetrics, and gynecology, lacking manpower and thus many people are not able to receive timely treatment. He also cited the imbalanced distribution of medical services between urban and rural as one of the reasons to expand the enrolment of medical students.[5] According to data from the Organisation of Economic Cooperation and Development (OECD), an organization composed mostly of developed countries, South Korea has one of the lowest doctor-per-patient ratios among its members, at 2.6 per 1,000 people—far below the average of 3.7 per 1,000.[6][7] Austria, in contrast, has one of the highest ratios at 5.5 per 1,000.[6]

Number of medical school graduates per 100,000 population, OECD Health Statistics 2023[8]
Country Number
 Denmark
22.0
 Italy
18.2
 Australia
15.4
OECD average
14.2
 United Kingdom
13.1
 Germany
12.4
 United States
8.5
 South Korea
7.3
 Israel
6.8

On the other side, doctors believe that the shortage of manpower in some locations is not due to insufficient numbers, but rather to inadequate medical resources and treatment in those locations that made it difficult to retain staff there. The Korea Times writes that even with the increased enrolment, upon graduation they may choose to go to more popular specialties or urban areas such as Seoul where there are more patients and higher salaries.[5] Medical professionals point out that the planned enrolment increase will not be able to fix the immediate manpower issue as training of doctors typically takes ten years.[6] Meanwhile, medical professors argue that the plan would impair the quality of medical education. In response commentators point out student-to-faculty ratio in Korea is one-third of Germany's and half of the United States, with each Korean medical professor handling 1.6 medical students on average.[7]

Medical professionals also point to high rates of medical malpractice litigation. Approximately 750 South Korean doctors are criminally charged for medical malpractice every year. That is 14.7 times higher than Japan, 580.6 times higher than the United Kingdom, and 26.6 times higher than Germany. A 2019 study found that one-third of doctors had experienced medical malpractice in the 3 years prior to the study. These accusations often occur in more critical medical specialities, such as emergency medicine, cardiothoracic surgery, gynecology, and pediatrics.[4]

Rural areas in South Korea lack medical infrastructure, and patients prefer to travel long distances to large medical centers in Seoul. Therefore, the development of rural medical care has never improved, and doctors are even less willing to go there to start their careers.[4]

Strike[edit]

Seoul National University Hospital in Seoul

In South Korea, if medical students want to qualify as medical doctors, they must first undergo a one-year internship and four-year residency training after graduation.[9] Since 2006, the enrolment quota for medical schools has been 3,058 per academic year.[10] Successive governments wanted to increase the enrolment quota but were unsuccessful due to the opposition from doctors. The authorities predicted that by 2035, there would be a shortage of doctors, therefore Yoon Suk Yeol's government announced on February 6 that they will increase enrollment by 2,000 every year from 2025 onward.[10] Doctors have collectively opposed the increase in enrolment, stating there are sufficient numbers of doctors in the major hospitals.[11] Even so, the government stood by the plan.[12]

  • February 20

Many doctors resigned collectively.[13] Many medical students also went on strike and suspended their studies.[12]

  • February 26

Ministry of Health and Welfare stated that among the 100 hospitals, 10,034 interns and resident doctors submitted resignation letters with 9,006 of them resigned.[14] In response, the Ministry suspended the medical licenses of two leaders of the Korea Medical Association and ordered the return of 6,228 intern doctors.[15] The government indicated that if they resumed their work by February 29, they would not be punished.[16] On March 1, there were 565 doctors who had yet to return to their duties.[17] The government stated that they would take action against those who refused to return to work from March 1 opposing administrative sanctions and other possible judicial measures.[18]

  • March 3

The Korea Medical Association held a general meeting at Yeouido island located on the Han River in Seoul, condemning the government's pressure on the doctors and mobilizing doctors to continue the strike to stand against the government.[19]

  • March 4

The Ministry announced that it would conduct a second inspection at 50 hospitals for the return of intern and resident doctors. If these doctors returned to their posts by then, they would not pursue further discipline. However, if the inspection revealed that they had not returned to work, they would face punishments on the following day. Those who did not comply with the government's order to return to work would have their medical licenses suspended for at least three months, delaying their qualification as medical doctors by more than a year. Further administrative sanctions and reasons would also be recorded in their employment records.[20][21]

  • March 8

At 11:00 am local time, more than 11,994 intern and resident doctors remained absent, representing 92% of the trainee doctors.[7] On March 11, the Ministry had issued a notice of suspension of medical licenses to 5,566 intern and resident doctors.[22] The Ministry indicated that those who returned to work before the completion of notification process would be dealt with leniently.[23]

  • March 9

The medical schools had received 5,445 applications to study medicine.[24]

  • March 16

Senior doctors and professors from 20 hospitals had indicated that they would submit their resignation letters from March 25 onward backing the current strike.[25] The medical professors began cutting back on the hours spent in practice on March 25 instead.[26]

Reactions[edit]

Government[edit]

South Korean President Yoon Suk Yeol lambasted the strike and denied that the increase in medical students will lead to a decline in the quality of medical education. He stated that the strike should not threaten the lives and health of the population, and that the proposed increase of 2,000 students is the minimum required.[27][28] His government stated that if the doctors on strike did not return to work, their medical licenses would be suspended.[12]

  • February 22

The government raised the crisis level of the country's medical system to "serious".[29]

  • February 23

The Ministry of Health and Welfare announced that all clinics and treatment centers are allowed to provide telemedicine services.[30]

  • February 27

The Ministry announced that nurses would be able to assume some duties of doctors.[31] On March 1, the Ministry issued a return to work order to 13 intern and resident doctors who formed the committee of the Korea Intern Resident Association.[32]

  • March 3

South Korean Prime Minister Han Duck-soo chaired a response meeting, acknowledging that a large portion of the doctors had yet to return to work. Han stated that the government would urgently prepare a budget to employ replacement doctors and reward those who stayed in the hospitals. Various committees under the government would also work to implement health care reforms.[33]

In order to ensure that regional emergency centers are able to treat severe cases, the Ministry began to classify patients into critical and non-critical groups.[22]

  • March 11

On March 11, the government announced that military doctors and doctors from public health clinics would be deployed to hospitals affected by the strike.[34]

  • April 4

President Yoon gave a speech to the nation for almost an hour. He reaffirmed his will to expand the number of medical school admissions and appealed to the public for support.[35]

"As the president, I regret not being able to promptly address the public inconvenience... All rational people will agree that the country faces a shortage of medical doctors."

— Yoon Suk Yeol, President of South Korea

Opposition parties and the public[edit]

Lee Jae-myung of the Democratic Party also opposed the strike and supported the increase in enrolment of medical students.[36] Groups representing cancer and ALS patients have also called for the quick return of striking doctors.[37] The Korean Buddhist order, Jogye Order had also urged the return of striking doctors on February 22.[38] A Gallup Korea poll found that 76% of those polled supported the increase in enrolment, with only 16% opposing it.[39] A survey published on March 5 by the Yonhap news agency found 84% of respondents supported adding more doctors, while 43% indicated that the doctors on strike should be sternly punished.[6]

Unions[edit]

The Korea Medical Association stated that the right to strike and resign by doctors are protected by the constitution.[40] The Korea Intern Resident Association wanted the government to withdraw the plan to increase the enrollment of medical students and cancel the return to work order.[14]

Impact[edit]

Severance Hospital, Seoul National University Hospital, and many other hospital were forced to cancel or postpone many surgeries.[41] Some hospitals also decided to shorten the time to operate on patients or give priority to critically ill patients.[42] Social media users complain about delays caused by the strike. One blames them for the death of their grandmother.[43] One woman, who died from a cardiac arrest in an ambulance, was turned away from seven hospitals due to a lack of staffing and beds, before being admitted to a public university hospital 67 minutes from when she first called for help.[2][44]

See also[edit]

References[edit]

  1. ^ "전공의 오늘 병원 떠난다…"수술 어떡해" 의료대란 현실로". 연합뉴스. February 20, 2024. Retrieved February 20, 2024.
  2. ^ a b "South Korean woman dies as doctors strike continues". February 27, 2024. Retrieved March 17, 2024.
  3. ^ "韓國醫師罷工吐心聲：過勞低薪且無人聞問". February 26, 2024. Archived from the original on March 9, 2024. Retrieved February 27, 2024.
  4. ^ a b c "韓國醫學生名額將增65%，為何引發醫生罷工？｜天下雜誌".
  5. ^ a b "存档副本". February 26, 2024. Archived from the original on March 13, 2024. Retrieved February 27, 2024.
  6. ^ a b c d Davies, Ed; Shin, Hyonhee (March 6, 2024). "Explainer: Why South Korean doctors and the government remain at odds over walkout?". Reuters.
  7. ^ a b c "South Korean Doctors Should Return to Duty". thediplomat.com. Retrieved March 17, 2024.
  8. ^ "Medical graduates". OECD library.
  9. ^ "전공의 '주 80시간' 장시간 근무". KBS. February 21, 2024.
  10. ^ a b "韓國學額風波 揭醫療系統爭議 醫生辭職抗議 總理警告勿以人命要脅". 明報新聞網 - 每日明報 daily news (in Chinese). February 19, 2024. Retrieved February 22, 2024.
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  12. ^ a b c "'집단사직 전공의' 831명 업무개시명령…'면허 박탈' 경고". KBS. February 20, 2024.
  13. ^ "South Korea doctors' strike could escalate as medical professors threaten to resign". CNA. Retrieved March 15, 2024.
  14. ^ a b "韓國政府和醫療界矛盾持續激化，多家醫院將手術日程削減一半". 央視網 (in Chinese). February 22, 2024. Retrieved February 22, 2024.
  15. ^ "兩天近9000名韓國醫生辭職 政府準備提控罷工醫生". 聯合早報 (in Chinese). February 21, 2024. Retrieved February 22, 2024.
  16. ^ "南韓辭職醫生破萬 政府指若在周四前復工將不追究". Now 新聞 (in Chinese). February 26, 2024. Retrieved February 26, 2024.
  17. ^ "韩国100家大型医院中已有565名辞职医生返岗_中国网". 中国网新闻中心_传递中国价值. March 1, 2024. Retrieved March 3, 2024.
  18. ^ "韩国近300医生复工 政府明起处分未返岗医生". 联合早报 (in Chinese). February 29, 2024. Retrieved February 29, 2024.
  19. ^ "韩国医协谴责政府对医生施压称将继续抗争". 韩联社（韩国联合通讯社） (in Chinese). March 3, 2024. Retrieved March 3, 2024.
  20. ^ "韩国政府：将现场检查医生出勤情况 未复岗医生执照将被吊销至少3个月". 新闻频道_央视网(cctv.com) (in Chinese). March 4, 2024. Retrieved March 4, 2024.
  21. ^ "韓國政府祭鐵腕行動，七千名實習醫生遭吊銷執照". Yahoo News (in Chinese). March 4, 2024. Retrieved March 4, 2024.
  22. ^ a b "首尔大学医学院教授或集体辞职 韩国保健福祉部称将与医生对话". 新闻频道_央视网(cctv.com) (in Chinese). March 12, 2024. Retrieved March 12, 2024.
  23. ^ "韩政府向近5000名拒不返岗医师发送吊销执照通知". 韩联社（韩国联合通讯社） (in Chinese). March 11, 2024. Retrieved March 11, 2024.
  24. ^ "韓國醫師罷工延燒 近3成醫學生有效申請休學". 中央社 CNA (in Chinese). March 10, 2024. Retrieved March 11, 2024.
  25. ^ "South Korean senior doctors to resign in support of junior medics' walkout". CNA. Retrieved March 17, 2024.
  26. ^ "South Korea's medical professors join protests, reduce hours in practice". TODAY. Retrieved March 26, 2024.
  27. ^ "'의대증원 = 질 저하' 주장에 대한 대통령의 반박 [현장영상]". KBS. February 20, 2024.
  28. ^ "韓國逾千醫生罷工 癌症患者求醫無門". 大公文匯網 (in Chinese). January 29, 2024. Retrieved February 22, 2024.
  29. ^ "超9000名医生集体辞职！韩国医疗系统危机升至最高级-新湖南". 新湖南_湖南新闻第一端 (in Chinese). February 22, 2024. Retrieved February 22, 2024.
  30. ^ "韓國醫生罷工潮持續 衛生部准所有醫院診所遠程診療". 香港01 (in Chinese). February 23, 2024. Retrieved February 23, 2024.
  31. ^ "韩国保健福祉部宣布即日起调整护士业务范围 承担部分医生业务". 川观新闻 (in Chinese). August 11, 2020. Retrieved February 27, 2024.
  32. ^ "韩政府医界返岗令时限已过 即将采取行政司法处分". 韩联社（韩国联合通讯社） (in Chinese). March 3, 2024. Retrieved March 3, 2024.
  33. ^ "韩总理：将采取措施应对非法离岗医生". 韩联社（韩国联合通讯社） (in Chinese). March 3, 2024. Retrieved March 3, 2024.
  34. ^ Yim, Hyunsu (March 11, 2024). "South Korea deploys military, public doctors to strike-hit hospitals".
  35. ^ "Yoon refuses to back down on medical school quota hike". The Korea Times. April 4, 2024.
  36. ^ "이재명 "의대 순차 증원이 마땅…의사 파업 즉각 중단해야"". KBS. February 21, 2024.
  37. ^ "중증질환자·시민단체 "병원으로 복귀해달라"". KBS. February 21, 2024.
  38. ^ "조계종, 전공의 복귀 호소…"생명은 무엇보다 존귀"". KBS. February 22, 2024.
  39. ^ "South Korean Trainee Doctors Protest Government's Quota Plan". TIME. February 16, 2024. Retrieved March 17, 2024.
  40. ^ "의협 비대위 "전공의 사직은 기본권 행사…위헌적 행태 중단하라"". KBS. February 20, 2024.
  41. ^ "전공의 없는 빅5 병원 '올스톱'?…중증·응급 진료 최우선". KBS. February 22, 2024.
  42. ^ "전공의 집단 이탈 의료 파행 본격화…전국 병원 비상 운영 돌입(종합)". 네이버 뉴스 (in Korean). February 20, 2024. Retrieved February 22, 2024.
  43. ^ 박 (February 22, 2024). ""신장 투석 대기 중 할머니 사망…의사 존경한 내가 한심" 손자 울분". 머니투데이. Retrieved February 22, 2024.
  44. ^ "S. Korea probes whether woman's death linked to doctor walkout". The Star. Retrieved March 17, 2024.
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