Recently, South Korea's medical and political circles have fallen into a "hard war".
The incident originated from the expansion plan of medical schools announced by South Korea** in early February - starting from 2025, the number of new students enrolled in Korean medical schools will increase from 3,058 to 5,058 per year, an increase of 65%. Since mid-February, thousands of doctors and medical students in South Korea have responded with strikes and class strikes,** warning of "revocation of licenses and arrest investigations" for refusing to return to work.
Seventy percent of doctors went on strike.
Yonhap News Agency, citing data from the Ministry of Health and Welfare, reported that as of the evening of the 21st, 9,275 interns and resident doctors in 100 hospitals in South Korea had submitted resignation reports, of which 8,024 had left their posts.
According to Yonhap News Agency, the total number of interns and residents in South Korea is about 130,000 people, 95% of whom work in the above 100 hospitals.
It is conceivable that more than 70% of doctors will have a great impact on these hospitals and patients. Therefore, South Korea issued a warning on the 21st that some doctors had previously been ordered to return to work, and doctors who continued to participate in the collective resignation action would be severely punished and face arrest and prosecution. According to South Korea's "Medical **", doctors can be ordered to return to work, and those who violate the order can be banned from practicing medicine for up to one year, or even sentenced to up to three years in prison.
South Korea's prime minister said that from February 23, he will comprehensively expand telemedicine services to provide more convenient medical services for the people. South Korea** will also open new wide-area emergency rooms in four regions early next month to handle the transportation and transfer of severe and critically ill patients.
In addition, the South Korean Ministry of National Defense said at a regular meeting that military doctors can be put into use when needed, and the emergency rooms of 12 military hospitals, including the South Korean Army's Capital Hospital, can be opened.
Is there a real shortage of doctors?
It is not new for doctors to take the risk of breaking the law and be "tough", and the focus of the dispute between the two sides is whether the medical school needs to expand its enrollment.
In fact, among developed countries, South Korea's doctor-to-population ratio and the number of doctors per capita have been at the bottom for a long time. As of July 2023, South Korea has the second-lowest number of doctors per 1,000 people (3 doctors per 1,000 people) in the OECD. Korean medical schools have not expanded their enrollment since 1998.
On the other hand, becoming a doctor in Korea is also a long and difficult process. In order to become a medical student, you must be within the top 1,000 in the college entrance examination, and the score of the medical school of a local university is even higher than the cut-off score of Seoul National University. Moreover, after being admitted, you have to pay high tuition fees, it takes 5-8 years to go to medical school, and it takes 5-8 years to go from intern to resident, and the cost of money and time to train a doctor is very high.
Therefore, South Korea has been seeking to solve the problem of "shortage" of doctors by expanding recruitment. However, the doctors who oppose the expansion emphasize that the number of doctors is not insufficient, but the problem of medical policies, systems and the distribution of doctors: first, the level of medical care in different regions is polarized; Second, there is a serious differentiation in the remuneration and work intensity of different specialties, such as medical cosmetology, ophthalmology, orthopedics, etc., have good business prospects, many items outside the medical insurance, and doctors have a high degree of freedom in elective medical treatment, and the number of practitioners has increased year after year, while specialties such as pediatrics, obstetrics and gynecology, and general surgery have high work intensity and are easy to cause medical lawsuits, and gradually no one cares. They believe that if the problem of medical resource allocation cannot be solved, then blind expansion will not help.
Will there be another "compromise"?
While the doctors' arguments are based on some reality, critics argue that opposition to the expansion "stems from fear of hurting their own economic interests." According to reports, Korean doctors are currently one of the highest-paid groups of doctors in the world. According to 2022 data, the average annual income of specialists in South Korean public hospitals is nearly $200,000.
It is worth noting that in the process of confrontation with **, industry associations such as the Korean Medical Association played a very important role. Because more than 95% of hospitals in South Korea are privately owned, it is easy for industry associations to unite practitioners. According to South Korea, since 2000, doctors have organized many large-scale strikes on plans such as the division of medicine, non-face-to-face diagnosis and treatment, and the expansion of medical schools, and each time they have retreated.
In July 2020, Moon Jae-in**, who was in power at the time, proposed a plan to expand the enrollment of medical schools, planning to expand the number of students by 400 per year for 10 years. The expansion was only one-fifth of the latest plan at the beginning of February, but it was met with fierce resistance from groups such as the Physicians' Association: 83 in two months9% of residents and 32Six per cent of specialists refused to make visits. Coupled with the factors of the new crown epidemic, the then ** could only compromise in the end, which also became a major failure during the Moon Jae-in administration.
But this time, Yoon Suk-yeol ** will obviously not give in easily. First of all, the expansion plan is only part of a package to reform local medical and basic medical care, and other plans also include the introduction of a local contract doctor system, reducing criminal penalties for medical malpractice, and increasing investment in obstetrics and gynecology, pediatrics, surgery, etc., which can also alleviate the problems raised by doctors to a certain extent; Secondly, the reform plan has also won the unanimous opinion of all parties within the country, and even partially recognized by the medical community, and the Korean Hospital Association has publicly agreed to expand the enrollment; Third, medical reform is also the will of the people, the social situation of the aging population is becoming more and more serious, so that the people feel the urgency of the shortage of doctors, according to the survey results of the polling agency, 76% of the respondents "positively evaluated" the expansion policy; Finally, there is political need, the South Korean National Assembly is approaching, and Yoon Suk-yeol has not been able to do anything in diplomacy and economy since he came to power, just to see if he can grasp the straw of medical reform, and there is no way to retreat, and he can only continue to be "tough".
Text: Yangcheng Evening News Weekend Special Chief Writer Xie Mingtu Visual China, etc.