Spat had escalated in South Korea over higher medical school admissions, pushed by the government in preparation for the rapidly aging society but opposed by local doctors for fear of the undermined quality of medical care.
Out of around 13,000 medical interns and residents, almost 10,000 submitted resignations and stayed off the job for nearly a month, while some 40 percent of medical students took leaves of absence to stand in solidarity with trainee doctors by boycotting classes.
Medical professors were about to follow in the footsteps of their students as the emergency committee of professors at 16 medical schools among the country’s combined 40 medical colleges decided to turn in resignations on March 25 in support of their students’ walkouts.
South Korean Vice Health Minister Park Min-soo said on local broadcaster YTN Sunday that the cycle of a collective action in the medical community should be broken, calling the collective resignation decision by medical professors an “intimidation of people.”
The professors, who work as doctors at major hospitals, said they will continue to see patients until their resignations are accepted to stave off a possible healthcare collapse, but the collective action itself will add hardships to patients already faced with cancelled surgeries and reduced medical services.
INCREASING MEDICAL SCHOOL ADMISSIONS BY 2,000
The government announced its four-pronged essential healthcare policy package in early February, including a plan to increase medical school admissions by 2,000 starting next year in a bid to tackle doctor shortages especially in essential specialties and rural areas amid the rapidly aging population.
South Korea’s doctor-to-population ratio stood at 2.1 per 1,000 people in 2023, marking the lowest among members of the Organization for Economic Cooperation and Development (OECD), the Ministry of Health and Welfare said.
Even including practitioners of traditional Korean medicine, the ratio ranked the second lowest of 2.6, far below the OECD average of 3.7. With the data, the health ministry raised an urgent need to expand the current medical school enrollment of 3,058 that had been left unchanged since 2006.
Some of local doctors claimed that the government-set medical school quota hike may lead to oversupplied doctors on the back of the falling population, but the health ministry said the aging population will strengthen demand for doctors with the number of doctors necessary for 10,000 people aged 65 or older standing at 61.5, nearly five times larger than 12.8 for those under 65.
Moreover, domestic doctors had been swiftly aging. The proportion of doctors aged 65 or older was 8.2 percent of the total in 2021, and it was forecast to hit 30 percent by 2035, according to the health ministry estimates.
To address the shortage of physicians in essential fields and rural areas, the government planned to invest over 10 trillion won (7.5 billion U.S. dollars) by 2028 on appropriate reimbursement for essential medical care while offering incentives for doctors to work in remote areas.
Local physicians tended to avoid essential fields, such as pediatrics, obstetrics and emergency care, as compensation for such fields was fixed by the government at levels sometimes lower than costs under the national health insurance system.
It encouraged young doctors to work in highly-paid departments such as plastic surgery and dermatology that are not insured under the government system.
RESPONSE TO THE PACKAGE
Following the government’s announcement of the healthcare policy package, the Korean Medical Association (KMA) speaking for the majority of doctors said in a statement that it had closely consulted with the government decades of times since January last year on how to normalize essential medical fields and regional practices.
The KMA noted that it agreed to the government’s overall policy direction, but it stressed that the increased medical school admissions would not be a fundamental solution but end up with the degraded quality of medical education and services.
The Korean Intern Resident Association (KIRA), a major group representing junior doctors, said that the figure 2,000, by which the government pushed to lift medical school enrollments, was both scientifically groundless and politically motivated to garner votes in the upcoming parliamentary election in April.
The KIRA criticized the government for treating trainee doctors like criminals through violent measures, such as the suspension of medical licenses, the police raid of the KMA offices, the overseas travel ban on the KMA officials, and threats to indict and arrest those responsible for the collective resignations.
The association urged the government to revisit how many medical students could be increased or decreased along with doctors and improve training environment for junior doctors, whose average working hours amounted to 77.7 hours per week, doubling the average workweek of 38.3 hours for other employees.
According to health ministry data, medical interns and residents were annually paid 68.8 million won (51,650 dollars) and 72.8 million won (54,650 dollars) each in 2020, below a third of 236.9 million won (177,850 dollars) for specialists.
An annual income of general practitioners was far less than specialists at 142.3 million won (106,830 dollars), which was bigger than 109 million won (81,830 dollars) for pediatricians in private practice, whose treatment was insured for the most part under the national health insurance system.
Public opinion had changed amid a prolonged confrontation between the government and doctors. In mid-February, 76 percent of respondents positively saw the medical school quota increase, but those in favor of the government’s push to raise the quota by 2,000 declined to 47 percent in mid-March, according to Gallup Korea polls.
A combined 41 percent said the government and the medical community should reach a compromise to adjust the scale and timing of augmenting medical school admissions.
Source: Xinhua
