By THE NEW YORK TIMES
Six weeks after thousands of residents and interns at South Korean hospitals walked off the job, frustration is rising.
Patients have filed more than 2,000 complaints about surgeries and other treatments being postponed, canceled or refused, according to the national health ministry. Hospitals have closed wards and restructured staff. Nurses have taken on duties usually performed by physicians, and military doctors have been deployed to public health centers.
Much of the anger over the disruptions is aimed at President Yoon Suk Yeol, who has not backed down from his proposal to dramatically expand medical school admissions to address a shortage of physicians. The young doctors who walked out in February to protest that plan say it wouldn’t solve the health care system’s problems.
But many people are also exasperated with the doctors, despite the exalted position that physicians hold in South Korea’s hierarchical society. Critics accuse them of trying to protect their elite status, and their income, by keeping the number of doctors low.
“Doctors are one of the richest and most powerful groups in Korea,” said Lee Chun-hee, a 26-year-old office worker in Seoul. “They need to be humbled.”
South Korea has fewer physicians per capita than most countries in the developed world — 2.6 doctors per 1,000 people, compared to an average of 3.7 in the countries belonging to the Organization for Economic Co-operation and Development. Surveys have found that most South Koreans want more medical students enrolled to address that. In one recent poll, 43 percent of respondents said the physicians who’ve stopped working — they currently number 12,000 — should face legal consequences.
For some doctors, that is a startling message to hear from their patients.
“When they’re sick and come to us for treatment, they seek us out with a heart of gratitude. But when it comes to public policies or large social issues, it appears the public wants the doctors to be the ones to compromise,” said Dr. Kim Daejung, a professor of endocrinology and metabolism at Ajou University Hospital in the city of Suwon.
“Public sentiment toward doctors is two-sided,” Dr. Kim said. “While they are admired and respected, they are also the target of envy and anger.”
Doctors have prestige everywhere, but that is particularly true in South Korea. Kye Bongoh, a professor of sociology at Kookmin University in Seoul, attributes that to a strong belief in the educational hierarchy. Many top students choose medicine over finance or other corporate paths — partly because of its high social status, but also because it is seen as offering more financial stability in the long term.
“When people hear the word ‘doctor,’ they assume they were first in their class since high school,” Professor Kye said. “And since they go through arduous training to be a doctor, they’re highly respected.”
Dr. Kim, who got his license in 1993, remembers when high achievers were just as likely to enter fields like engineering, which promised well-paying jobs with big firms. But medicine started looking like a better bet after the Asian financial crisis of the late 1990s, which put thousands of companies out of business.
“Becoming a doctor was seen as a more stable path,” Dr. Kim said.
Because South Korean health care is relatively cheap, government-subsidized and easily accessible, patients can go “medical shopping,” as Dr. Seo Yeonjoo, a 33-year-old specialist in the internal medicine department at St. Vincent Hospital near Seoul, put it. This has led to something like a star system, doctors say, as patients seek out highly regarded physicians who’ve gone to top schools.
“Lots of people come to the big hospitals seeking out these big-time doctors,” said Dr. Seo.
The young “trainee doctors” who’ve walked out say their situation is very different. They work grueling shifts, often for what amounts to less than minimum wage, once the long hours are factored in. But some South Koreans are skeptical, saying that lucrative, comfortable careers await them once they’ve put in their five years as interns and residents.
“There is no way to explain why doctors are opposed to increasing the number of doctors, other than the idea of making more money at the expense of patients,” the Chosun Ilbo newspaper said in an editorial.
This isn’t the first time doctors have pushed back against attempts to expand medical school admissions. There was a walkout in the summer of 2020, after then-President Moon Jae-in proposed a more modest increase. Faced with a strained medical system at the height of the Covid pandemic, the government backed down.
But Professor Kye said that when the public’s trust in physicians is shaken by such episodes in South Korea, it tends to rebound quickly.
“While there might be animosity toward doctors now, our culture of seeking out revered doctors for treatment, and the long-held perception of them, is unlikely to change,” he said. In 2021, a year after the last walkout, surveys found that around 60 percent of the public thought the medical system had responded well to the pandemic.
Yoon Jong Min, 54, who had surgery on his leg in October, was due for a follow-up visit last month. Because of the walkout, it was postponed to mid-April, and the Seoul hospital where he was treated could not guarantee that it wouldn’t be delayed again, he said.
But he blames the government more than the doctors for the standoff. “I’m being harmed by the administration’s political show,” he said. He said that medical school admissions should be increased, but gradually.
President Yoon’s plan would raise medical school admissions — to around 5,000 students per year, from around 3,000 — starting next year. It would also spend 10 trillion won, or $7.5 billion, over the next five years on improving health care services, especially in rural areas that the government says are underserved.
The doctors, along with other critics of the government, say the plan was hastily put together to win votes in legislative elections this month. The doctors say it would do little to alleviate the physician shortage, which they say is concentrated in certain departments, like emergency care.
Civic groups have urged the doctors and the government to end the dispute. “Will they put this abnormal situation to end only after patients die from not being treated on time?” the Korea Alliance of Patients Organization said in a statement last week.
In a televised speech this week, Mr. Yoon defended his plan, saying that 2,000 more medical students per year was the “minimum” needed. But he also invited doctors to submit a counterproposal and offered to meet with them. A major doctors’ group welcomed that offer but said any talks would have to be “meaningful.”
Dr. Kim, the Ajou University Hospital professor, said the country’s attitude toward his profession was unlikely to change, whatever the outcome of the dispute. “People might be angry at doctors now, but they will still want their children to become one,” he said.
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