It was shocking to see the doctors go on strike. After all, these professionals are tasked with caring for the rest of society, including treating the sick and wounded. In South Korea, however, this surprising development took place precisely in the world.
Since February, more than 12,000 doctors in more than 100 hospitals have gone on strike to protest the government's policy of increasing medical school enrollment. Medical students, interns and residents were among the first to strike, followed by senior doctors and professors of medicine.
That's just a fraction of South Korea's roughly 140,000 doctors, but the strike has led to hundreds of surgeries and other treatments being canceled.
The reason for this is that South Korea's healthcare industry is plagued by pay and working conditions issues and needs to be reformed, but earlier attempts at compromise and incremental change have failed.
Since 2016, the annual enrollment cap for medical schools in South Korea has been 3,058. In 2020, the Moon Jae-in administration proposed a modest increase of 400 places per year to address the shortage of doctors. Doctors strongly opposed the proposal and went on strike, fearing that they would have to share more of the medical industry's revenue.
Their actions are taking place against the backdrop of the coronavirus pandemic. Due to the urgent need for medical care, the government capitulated. Doctors returned to work "triumphantly" a month after the strike, preventing an increase in the number of doctors.
This time, President Yoon Suk-yeol's administration initially proposed to increase the number of students enrolled in the medical school by 2,000 per year. Once again, the doctors responded with anger and indignation. This reaction is not surprising. If they refused to add 400 students in 2020, they would certainly refuse to add 2,000 students.
Healthcare issues in South Korea
The Korean healthcare system has excellent features. In 2024, the International Healthcare Index ranked South Korea's healthcare system second in the world. South Korea also exports its expertise to other countries, including Korean medicine collaborations, training programs, and academic exchanges.
Regular public health check-ups are free for citizens and long-term residents. The low cost of seeing a doctor and receiving basic prescription drugs is also a major advantage of the system.
General medical services in Seoul are very convenient. However, the population is rapidly aging, sparking debate about whether there are enough doctors at the moment. Research by the Korea Institute of Health and Social Affairs suggests that South Korea may need to add 27,000 doctors by 2035 to meet demand.
One of the main problems is the uneven distribution of doctors between urban and rural areas. There are 3 doctors per 1,000 inhabitants in urban areas, while 1.6 doctors per 1,000 inhabitants in rural areas.
Doctors are reluctant to practice in rural areas. There are several reasons for this: In the 2020 Korean Doctor Survey, 58% of doctors surveyed said that "children's education" was the top reason for their reluctance to move to the countryside. This was followed by "living away from family" at 53%.
Another problem is the uneven distribution of different specialists. A large number of doctors are being pulled into lucrative industries – a problem that is not unique to South Korea. Over the past 10 years, the number of plastic surgeons in Korea has increased by 76% and the number of dermatologists has increased by 39%.
Known as the "plastic surgery capital of the world," South Korea attracted a record 606,000 foreign patients last year, up from 248,000 the year before.
Specialties such as obstetrics are less popular due to concerns about lawsuits. According to the Korean Medical Doctor Association, Korean doctors are at a higher risk of being sued by their patients than in other countries. It is estimated that about 750 South Korean doctors each year, or more than two on average per day, are criminally charged for professional negligence resulting in death or injury.
Where does the number 2000 come from?
From the perspective of the country's public health situation, the striking doctors are clearly wrong. The public has little sympathy for them, because people know that the country needs more doctors. More than 70% of citizens support increasing the number of places available in medical schools.
At the same time, perhaps a little paradoxical, more than 60% of citizens also believe that the government's approach is wrong. If doctors take the wrong position, it's not because the government has taken the right position. It was an event without heroes.
The current proposal to increase the number of places to enrol seems arbitrary. No one explained how the initial 2,000 figure came about. Why this number? How does it relate to the identified issue?
The lack of clarity in the logic of such a sudden, dramatic salary increase has drawn criticism. Criticism comes not only from the opposition, but also from politicians from the president's party.
One concern for the medical community is that medical schools are unable to accommodate the 2,000 new students a year.
Medical schools have now agreed that they can increase the number of medical staff, but they say 2,000 is too much for proper training. Doing so requires sharing more space, faculty, and equipment. As a result, there are concerns that the rapid increase in the number of medical students and doctors may lead to a decline in the quality of teaching, which in turn will lead to a decline in the quality of care for new doctors.
On the other hand, the proposal has also been warmly welcomed by the private tutoring community. The city of Seoul has opened a medical school program for elementary school students, which is expected to create a boom.
The expansion plan is advancing, and the education department has promised to increase the number of enrollment places by 1,500 next year.
The most obvious compromise is for the government to propose a smaller increase, which means a return to 2020 levels. If this is reached, it will highlight the absurdity of the current situation.