South Korea’s government and the country’s junior doctors are at a stalemate over a policy increasing the cap on medical student admissions. Neither side shows signs of backing down.
Thousands of trainee doctors resigned and have been on strike since Feb. 20 over the quota increase. Junior doctors comprise roughly 38% of doctors working in tertiary hospitals; nearly 95% of those doctors are striking, according to South Korea’s Ministry of Health and Welfare.
The Korea Times reports that a hiring program meant to fill the void of residents only received 104 trainee applicants. That comprises only 1.4% of the available positions.
Initially proposed to increase admissions by 2,000 per year, the finalized plan in May increased admissions by roughly 1,509 from the current 3,058. This marks the first increase since 2006.
In an interview with The Daily Utah Chronicle, National Assembly Member Kim Yoon of the Democratic Party of Korea said the finalized plan is a one-time quota increase for the 2025 class. South Korea will need to create new legislation to determine the quota for 2026.
The government argues that more students should be admitted to medical schools so that shortfalls in remote areas and specialties like pediatrics and emergency care can be filled.
A 2023 report by the Organization for Economic Co-operation and Development (OECD) shows that South Korea has the lowest ratio of doctors per 1,000 people among high-income OECD countries.
Concerns Over Income
Kim said trainee doctors vehemently oppose the quota increase because of concerns about their future incomes.
“When … they finish their resident training and get their full certification, they expect a certain amount of income … and they think when the number of physicians is increased, their future income will go down,” he said.
Some of South Korea’s doctors are the highest paid of any developed nation. Self-employed specialists have the highest average annual gross income among all OECD countries. However, these high salaries are not shared in all medical fields.
South Korea has a single-payer health care system, where the government finances all essential health care services. However, most doctors do not work for the state and receive fixed reimbursement rates for their essential services.
The reimbursements are often too low to cover costs in certain specialties, like pediatrics, so doctors flock to more profitable, non-insured fields like cosmetic surgery.
“The amount of uncovered services has been increasing rapidly because the prices are not controlled,” Kim said. “And so hospitals and physicians can earn a lot more money from uncovered services.”
Kim added that increasing reimbursements and pay for physicians in rural areas is needed to address doctor shortages.
The Korean Medical Association, the country’s largest union for senior doctors, argues that the quota increase will only lead to more doctors entering profitable fields instead of the specialties facing shortages, according to the Korea JoongAng Daily.
Trainees Strike
On June 18, the Korean Medical Association (KMA) staged a day-long walkout in solidarity with the striking trainees.
Kim believes an important reason for KMA’s opposition is the desire for doctors to maintain their veto power over government health policy. He added that past governments avoided making changes to quotas for fear of offending doctors. However, doctor shortages have become so drastic that the government can no longer afford to ignore the issue.
The Korean Medical Association did not respond to a request for comment. However, another possible reason KMA may oppose the quota increase is that medical schools do not have enough resources to train a rapid influx of students.
“The quality of medical education will plunge endlessly, resulting in a unsafe, low-quality medical service and eventually a collapse of the medical service of the Republic of Korea,” Lee Jeong-geun, former leader of the Korea Medical Association, said at a rally in March.
Kim said a trainee’s first two years of education are in premedical school, which has more educators than medical schools. This buys the government time to meet demands.
“Their concerns are legitimate, but we can address those issues in the next two years if we invest the right amount of resources and [enact the] right policies,” Kim said.
National Affects
A June 14 Gallup Korea Poll indicates that 66% of Koreans support the government’s quota increase. Of these, 48% believe doctors are more to blame for the standstill, and 38% hold the government primarily responsible.
The six-month strike has put some emergency rooms in a state of crisis.
According to the Korea Biomedical Review, Yangsan Hospital’s Regional Emergency Medical Center in Busan stopped providing most emergency surgeries. The Inje University Sanggye Paik Hospital’s emergency room in Seoul has closed its surgery departments on nights and weekends.
Over 90 patient advocacy groups staged a rally in Seoul in July, calling on doctors to end the ongoing strike.
“Patients and their families, as well as the public, are experiencing anger, anxiety and fatigue amid the conflict between the irresponsible government and reckless trainee doctors and medical professors,” the groups said in a joint statement.
Jio Son, a business major at the U Asia Campus, was the interpreter for the interview with National Assembly Member Kim Yoon.
