South Korean doctors oppose government plans to expand medical school enrollment

An ongoing dispute in South Korea between doctors and the Yoon Suk-yeol government over the expansion of medical school enrollment has led to the mass resignation of nearly 10,000 medical residents and interns at hospitals around the country.

Thousands of doctors rally against the government's medical policy in Seoul, South Korea, Sunday, March. 3, 2024. [AP Photo/Ahn Young-joon]

As of February 28, South Korea’s Ministry of Health and Welfare reported that 9,997 trainee doctors from approximately 100 hospitals had submitted their resignations over a week-and-a-half period in protest against the government’s agenda. Additionally, 9,076 trainees had walked off the job. There are some 13,000 residents and interns nationwide represented by the Korean Intern Resident Association (KIRA).

The Yoon government plans to expand enrollment at medical schools next year by adding 2,000 positions, up from the current level of 3,058, a cap which has existed for nearly two decades. Yoon claims this is necessary to better serve the public where there is a lack of doctors, particularly in rural regions and in fields like high-risk surgeries, pediatrics and obstetrics. In pediatrics, for example, between 2017 and 2022, the number of pediatric clinics decreased by 12.5 percent. Many hospitals have closed or significantly reduced emergency rooms for child patients.

KIRA and the allied Korean Medical Association (KMA), which represents more senior doctors, state that Yoon’s plan will lead to a glut of poorly trained doctors in popular fields without addressing shortages in other areas or providing doctors with necessary financial support.

Lee Jong-bok, the president of the KMA’s branch in the city of Wonju, stated last month: “The lack of doctors going into pediatric and adolescent medicine and the lack of doctors working in the countryside isn’t a matter of the number of doctors—it’s a matter of medical policy and institutions and the distribution of doctors.”

The KIRA and KMA have stated that the influx of new doctors would be used to expand competition among specialists in for-profit university hospitals in cities. This process is already well underway. According to the Korea Biomedical Review, between 2008 and 2018 medical fees surged at tertiary hospitals by 13 percent while dropping at local clinics by 20 percent.

They have also said that medical schools do not have the resources to train such a large number of additional medical students, meaning new doctors could be less qualified.

Speaking to the Hankyoreh newspaper last October, Sin Yeong-seok, a professor at the Korea University Graduate School of Public Health, stated, “There might be issues with education if the [cap] were increased suddenly by 2,000 to 3,000 students a year, but I think an increase of around 1,000 would be feasible under the current medical school environment.” Sin had taken part in a study by the Korea Institute for Health and Social Affairs finding that concluded that there would be a shortage of 27,232 doctors by 2035.

Trainee doctors have also voiced concerns about their working conditions. Speaking with the Nikkei Asia, a doctor identified only by her family name Na stated, “Because we are trainees, we are not supposed to be the ones who are running the hospital. We’re supposed to be there getting our education. But because of the skewed financial system, the only way for the hospitals to make ends meet is to make these poorly-paid trainee doctors work overtime.”

Interns and residents began taking job action on February 19. In addition, doctors protesting the government’s plan held a mass rally in Seoul on Sunday led by the KMA. The organization estimated that 40,000 had participated.

The Yoon administration has responded to the doctors’ walk-out by issuing back-to-work orders. Denouncing the ongoing job action as “illegal,” the government has threatened to arrest those who do not comply while revoking their medical licences. Health Minister Jo Gyu-hong warned that “health authorities will start on-site investigations to determine whether trainee doctors have returned to work and take measures under the law and principles, without exceptions, if they haven’t.”

Throughout the dispute, the government has sought to posture as a defender of the public’s safety and welfare. An official from the presidential office told Yonhap News over the weekend, “We are watching the situation in real time with regard to the threats to the public’s lives and health rights from the doctors’ collective action.”

Nobody should take the government’s phony concerns for public health as good coin. This is the same administration that has torn up all remaining COVID-19 safety measures—a process begun under the administration of Democrat Moon Jae-in—and engaged in the same criminal conspiracy as governments around the world to falsely declare that the pandemic is over.

When health officials stopped counting new COVID-19 cases at the end of last August, tens of thousands continued to be infected with a potentially debilitating and deadly virus on a daily basis. At that time, the official number of deaths stood at 35,934, yet excess deaths by the end of last year had exceeded 65,000 and have only continued to grow.

The doctors’ organizations, however, have largely limited their criticism of the government to the lack of communication in carrying out its agenda, with the KMA and KIRA opposed to the government’s encroachment on its perceived territory. Slogans at Sunday’s rally included the demand, “Absolute opposition to a medical school quota hike without agreement from medical fields.”

The KMA and KIRA are exploiting genuine concerns voiced by doctors to push their own agenda. These professional associations are not concerned with defending public health or improving the conditions of low-paid and overworked trainees. Instead, they are seeking to protect their own financial interests and those of the highly paid doctors opposed to increased competition from additional physicians.

In response to the government’s formal announcement on February 6, Kim Taek-u, the KMA’s emergency committee chief, declared, “Is this really the country I think it is? Is this a socialist country? Is this the republic of prosecutors? Hearing that the enrollment cap at medical schools would be increased by 2,000 people felt like a gut punch. Feb. 6 was a death sentence for Korean health care.”

The conflating of the plans of right-wing President Yoon, the country’s former prosecutor-general, with socialism is absurd but also revealing. Kim is essentially declaring that the KMA will brook no interference by any government in the medical profession that threatens the rights and privileges, particularly of its most affluent layer.

There is no doubt that more doctors in a rationally planned, socialist economy would benefit the public. But under capitalism, medical care is subordinated to the profit system, meaning the Yoon administration’s plan will benefit big business in the medical and other industries, not improve patient care.

Yoon has pledged the allocation of ten trillion won ($US7.5 billion) to supposedly support the new doctors and expand their employment in regional clinics. This is part of his government’s attempt to cover up its real agenda with populist measures, particularly ahead of this April’s general election for the National Assembly and to shore up Yoon’s low approval rating, currently around 40 percent.

Significantly, the Yoon administration’s plan is in part aimed at expanding the number of medical scientists and similar professionals in order to attract investment domestically and internationally from pharmaceutical and related businesses.

While discussing his healthcare plans, Yoon stated in October, “We also need to cultivate medical professions, not only clinical physicians but also medical scientists.” By expanding the number of medical school positions to 5,058, the government plans to nearly double the proportion of medical school graduates per year trained as scientists from 1.6 to 3 percent.

Seoul also plans to build what it calls an “ecosystem” to connect medical industries and research institutes while tearing up local regulations in order to further the interests of big business. It would bring together not only experts in medicine, but other fields such as engineering, finance and law as well as collaboration between companies producing semi-conductor chips and biotechnology.

This would also include what Yoon called a “bio alliance” between institutions like Seoul National University Hospital and the Massachusetts Institute of Technology (MIT), which would deepen the South Korean-US alliance. The development of such plans took place during Yoon’s trip to the US last April for his summit with President Biden.

These plans highlight the actual aims behind Yoon’s plans to expand medical training. It is bound up with the profit interests of big business and the broader collaboration with US imperialism in hi-tech industries as it prepares for war with China.