At noon on February 23, the Daejeon Fire Headquarters in South Korea received an emergency call**, and an elderly man in his 80s fell into a coma. During the ambulance process, seven hospitals refused to accept patients on the grounds that they had no beds, no doctors and medical staff in charge, and no way to treat seriously ill patients.
It wasn't until the 8th call that emergency personnel were able to contact the emergency room that could receive the patient. Unfortunately, on the way to the hospital, the patient suffered a cardiac arrest in the ambulance. Upon arrival at the hospital, the paramedics determined that the old man had died.
This is a microcosm of the turmoil of resignation of South Korean doctors in the past half month.
The emergency room of a hospital in Seoul, South Korea. Source: CCTV News.
Interns and residents, who account for 40 percent of doctors at South Korea's major general hospitals, began to leave their jobs on February 19, creating a huge medical vacancy in South Korea. Nearly half of surgeries in large hospitals have been postponed or cancelled, emergency patients have nowhere to be received, and patients have to wait for ...... six hours to see a doctor
South Korea** has also taken a tough stance. From the 5th, South Korea** sent prior notices of administrative sanctions such as revocation of licenses to nearly 9,000 off-the-job intern residents.
According to the Ministry of Health and Welfare, as of 20:00 on the 4th, the results of an inspection of 100 major internship hospitals showed that among the 9,970 intern residents with qualifications of one to four years, a total of 8,983 had left their posts, accounting for 901%。
The root cause of the detonation of South Korea's medical industry and "toughness" is the expansion plan of South Korea's medical universities announced in early February.
Source: CCTV News.
1. Hard-hitting. In South Korea, medical students have always been considered "the pride of heaven".
South Korea generally has about 500,000 college entrance examination students every year. Since 2006, the annual enrollment quota of the medical university has remained at 3,058.
In early February, the Ministry of Health and Welfare announced that it would increase the number of medical school students by 2,000 in the 2025 academic year, and increase it every year thereafter.
The Ministry of Health and Welfare's explanation for this is that according to ** and academic estimates, there will be a shortage of about 10,000 doctors in South Korea by 2035.
It takes 6 years to complete a medical school program in Korea (2 years for the preparatory department and 4 years for undergraduate). Therefore, the number of students enrolled from 2025 to 2029 will have to increase by 10,000, or 2,000 per year, to ensure that 10,000 new doctors will enter the health system in six years' time, between 2031 and 2035.
The emergency room of a hospital in South Korea.
But such a plan, which seems to be to improve people's livelihood and well-being, has been strongly supported by the doctors' community.
In the past half a month, more than 10,000 interns and residents have resigned from 100 large general hospitals in South Korea, more than 130,000 medical students from colleges and universities joined the ** program and applied for suspension, and some medical university graduates also gave up their internship contracts.
As the wave of resignations intensifies, the crisis level of South Korea's healthcare system has been raised to the highest level of "severe" for the first time in South Korea's history. **Temporary adjustment** of the scope of business to provide legal protection for **undertaking part of the work of doctors. South Korea's Ministry of National Defense has opened the emergency department of military hospitals to the public.
On March 4, the first day of school, students at a university in Daegu were suspended en masse, and the medical school classrooms were empty.
Despite the menacing noise in the medical community, South Korea shows no signs of compromise.
South Korean Prime Minister Han Deok-so said on the 3rd that he would not succumb to the collective resignation and resignation of the people's lives as hostages. **A special committee on health care reform will be launched this week to prepare for the advancement of health care reform.
The Ministry of Health and Welfare dispatched personnel to 50 hospitals on the 4th to inspect the return of interns and residents. The relevant person in charge said that serious measures will be taken against the core people who resigned and left their posts that caused chaos at the medical scene.
South Korean Prime Minister Han Deok-so presided over a meeting on March 3 of the "Headquarters for Disaster Safety Countermeasures to Respond to the Collective Action of Doctors."
In the face of pressure from South Korea, medical groups continue to choose to fight hard. The Korean Medical Association held a three-day national gathering of doctors on the 3rd. They said it was just "the beginning of a long journey for South Korea."
On March 3, the Korean Medical Association held a national gathering of doctors**.
From February 22 to March 4, South Korea** received applications for medical school enrollment places for the 2025 academic year from 40 universities across the country, resulting in a total of 3,401 additional applications. On the morning of the 5th, after the results were announced, more than 10 professors from the Gangwon National University School of Medicine held a hair-cutting ceremony in front of the teaching building, condemning the unilateral decision to increase the number of students without considering the professors' opinions.
Professors at the medical school cut their hair and opposed the hospital's decision to increase the number of staff.
2. What is the crux of the problem?
South Korea** pointed out that with the aging of the population, it has become a common practice in many countries around the world to expand the enrollment of medical students. However, South Korea has become the only country in the world that has caused a large number of doctors due to the expansion of medical schools.
One of the major shortcomings of South Korea's medical community exposed by the crisis is that most of the work in South Korea's large hospitals relies on interns and residents with relatively lower salaries but longer working hours.
The first two years of a Korean medical student's career are preparatory and then four years of undergraduate. In their junior year, they begin their internship at the hospital and prepare for the medical licensing exam. After passing the exam, you can officially enter the hospital - first as an intern for one year, then as a resident doctor for three to four years.
A hospital in Gwangju, South Korea. Source: CCTV News.
Interns and residents were the main force of this strike. These doctors account for about 40 percent of doctors in large hospitals, and do a lot of work in emergency rooms, intensive care units, and operating rooms.
They usually work around 80 hours a week. In other words, even if you work seven days a week, you have to work more than 11 hours a day.
In this case, is it the shortage of doctors that is causing doctors to be overloaded?
South Korea**, citing a November 2023 report by the Organisation for Economic Co-operation and Development, said that on the one hand, South Korea has only 2. per 1,000 people6 doctors, 37 places on average, the lowest among developed countries; On the other hand, the number of outpatient visits per capita in South Korea is 157 times, but it ranked first among member states.
The 2,000 annual enrollment is the minimum number determined based on medical supply and demand, not a negotiated number," South Korean Health and Welfare Minister Cho Gyu-hong stressed in a news program on February 23.
But the medical community has a very different view. According to a survey of more than 20,000 members of the Medical Doctor Association, 95% of respondents disagreed that there is a shortage of doctors in Korea. Doctors pointed out that the expansion of recruitment is not the root cause of the shortage of doctors, and that the reason for the overwork of doctors is the serious uneven distribution of medical resources.
A hospital in South Korea. Source: CCTV News.
More than 90% of South Korea's healthcare system is private. At the same time, South Korea's national health insurance coverage is extremely high, with almost universal health insurance. As a result, basic medical specialties with high reimbursement rates under medical insurance, such as pediatric and adolescent medicine, obstetrics and gynecology, emergency department, and surgery, have relatively limited income and chronic shortages. Due to the high income, young doctors of "skin and eye surgery" (** department, ophthalmology and plastic surgery department) with many self-funded projects are vying for jobs.
According to a survey by the Ministry of Health and Welfare, as of 2020, the average annual salary of ophthalmologists in South Korea is about 45.8 billion won (about 3 million yuan), * The average annual salary of doctors is 30.3 billion won (about 2 million yuan), which is higher than the average annual salary of doctors as a whole. In comparison, the annual salary of the pediatric and adolescent department is about 100 million won (about 540,000 yuan).
As of 2022, the number of plastic surgeons in South Korea has almost doubled, and the number of doctors has increased by about 40, thanks to unequal economic incentives.
However, pediatrics, obstetrics and gynecology, and surgery, which are closely related to the basic life and health of the people, are facing a "labor shortage". According to a survey conducted by the Ministry of Health and Welfare on the recruitment of residents in 2022, the application rate for plastic surgery is 1806, * 184 for the family1％。However, there are only about 25 in the pediatric and adolescent department, which is far from full.
A hospital in South Korea. Source: CCTV News.
Although the doctors' group is well-founded, many analysts bluntly say that the mentality of doctors is also an obvious "crowding effect", lest more people "crowd" to dilute their own interests.
Professor Kwon Soon-man, a public health expert at Seoul National University, believes that the significant increase in the total number of doctors means that the resources of doctors are no longer a strange commodity.
As a result of the massive expansion of medical students, many hospitals may abandon hiring current interns and residents after four to five years of internship and residency and are about to become specialists, in order to reduce costs. This makes many interns and residents feel that the future is bleak, and it is difficult to see the hope of "getting through".
3 How to end.
The expansion of medical school enrollment is a difficult medical reform problem in South Korea. Compared with the ** of flowing water, the iron-clad Korean doctor group occupies a strong voice in the past.
In 2020, his predecessor Moon Jae-in** proposed a move to increase the number of medical school students by about 1,000 students, but it also drew strong opposition from medical students refusing to participate in national exams, internships, and collective strikes by residents. Due to the fact that it was the time of the new crown epidemic, Moon Jae-in** finally chose to compromise in order to ensure the normal operation of the medical community, and his plan to expand the enrollment was finally abandoned.
Some commentators believe that what the previous South Korean medical reforms lacked was not courage, but sincerity. In South Korea, every time the medical reform triggers a doctor's strike, provoking conflicts between doctors and patients, and the ** who stands on the side of the patients has been able to boost the support rate. This makes reform a "ballot operation" and* will also be a topic of conversation during election season.
In April this year, South Korea will hold parliamentary elections, and Yoon Suk-yeol's National Power Party is regarded as "inevitable defeat" by major polls. In this context, Yoon Suk-yeol**'s attitude towards this reform is particularly tough.
According to a survey released by polling agency Gallup Korea on March 1, South Korea's ** Yoon Suk-yeol's approval rate for his administration was 39%, an increase of 5% compared with the previous survey, and the negative rating was 53%. In terms of positive reasons, 21% of respondents answered "medical student enrollment expansion policy".
On May 10, 2022, Yoon Suk-yeol attended the swearing-in ceremony. Source: Xinhua News Agency.
Judging from the current actions of South Korea, South Korea's medical reform is imperative. A relevant person from the South Korean ** office said on the 4th that **Yoon Suk-yeol expressed his stance on the expansion of the medical school in the medical community to carry out collective action** medical school, saying that freedom will come with responsibility.
Analysts believe that a paradox facing South Korea now is that medical reform must be carried out, but it is difficult to promote medical reform smoothly; Moreover, after implementation, it will not completely solve the existing problems of the Korean medical system.
South Korea** said that there is a rumor that "the possibility of a medical chaos in March will increase" is emerging in large hospitals. Most of the third- and fourth-year contracts for trainees and residents expired on 29 February, but many of the interns and assistant physicians who had been scheduled to accept the offer in early March indicated that they had declined to take up employment. The Korean Medical Association believes that from this month, many hospital interns and residents will gradually "disappear".
References: CCTV News, Xinhua News Agency, China News Weekly related reports on South Korea** (Yonhap News Agency, Korean Nationalities**, North Korea**, East Asia**) related reports.
Produced and coordinated by the Key Laboratory of Guangzhou **Media, Lin Chuanling, Guangzhou**, New Flower City, Editor: Lin Chuanling, Ma Junxian.