Yangcheng Evening News weekend special writer Xie Mingming
Recently, South Korea’s medical community and political circles have been locked in a “hard battle.”
The incident originated from the medical school enrollment expansion plan announced by the South Korean government in early February. Starting from 2025, South Korean medical schools plan to increase the number of new students enrolled each year from 3,058 to 5,058, an increase of up to 65%. Since mid-February, thousands of doctors and medical students in South Korea have responded with strikes and class strikes, and the government has warned that those who refuse to return to work will “revoke licenses, arrest and investigate.”
70% of doctors go on strike
Yonhap News Agency quoted data from South Korea’s Ministry of Health and Welfare as reporting that as of the evening of the 21st, 9,275 interns and resident doctors in 100 hospitals in South Korea had submitted resignation reports, of which 8,024 had left their jobs.
According to data from Yonhap News Agency, the total number of interns and residents in South Korea is about 13,000, and 95% of them work in the above 100 hospitals.
It is conceivable that the strike by more than 70% of doctors will have a great impact on these hospitals and patients. Therefore, the South Korean government issued a warning on the 21st. It had previously issued a return order to some doctors. Doctors who continue to participate in collective resignation actions will be severely punished and face arrest and prosecution. According to South Korea’s “Medical Law”, the government can order doctors to return to work. Those who violate the order may be banned from practicing medicine for less than one year, or even be sentenced to fixed-term imprisonment of less than three years.
The Prime Minister of South Korea stated that remote diagnosis and treatment services will be fully expanded starting from February 23 to provide more convenient medical services for the people. The South Korean government will also open new wide-area emergency rooms in four regions early next month to be responsible for the transportation and transfer of severe and critically ill patients.
In addition, the South Korean Ministry of National Defense stated at a regular meeting that military medical officers can be deployed when needed and the emergency rooms of 12 military hospitals including the South Korean Capital Hospital will be opened.
Is there really a shortage of doctors?
It is not new for doctors to take the risk of breaking the law and “tough” the government. The focus of the dispute between the two parties is whether medical schools need to expand enrollment.
In fact, among developed countries, South Korea has long been at the “bottom” in terms of the ratio of doctors to population and the number of doctors per capita. As of July 2023, South Korea has the second lowest number of doctors per 1,000 people (3 doctors per 1,000 people) in the OECD. Korean medical schools have never expanded their enrollment since 1998.
On the other hand, becoming a doctor in South Korea is also a long and difficult process. To become a medical student, the college entrance examination score must be within the top one thousandth. The score of the local university medical school is even higher than the score of Seoul National University. Moreover, after passing the exam, you have to pay high tuition fees. It takes 5-8 years to go to medical school, and another 5-8 years to go from intern to residency. Training a doctor is very costly in terms of money and time.
Therefore, the South Korean government has been seeking to expand the number of doctors to solve the “shortage” problem of doctors. However, doctors who oppose the expansion emphasize that the number of doctors is not insufficient, but a problem of medical policies, systems and doctor allocation: first, the medical level of different regions is polarized; second, the salary and work intensity of different specialties are seriously differentiated , majors such as medical aesthetics, ophthalmology, and orthopedics have good business prospects, have many chargeable items outside of medical insurance, and doctors have a high degree of freedom in elective medical treatment. The number of practitioners has increased year by year, while majors such as pediatrics, obstetrics and gynecology, and general surgery have high work intensity. , it is easy to cause medical lawsuits, and gradually no one cares about it. They believe that if the problem of medical resource allocation cannot be solved, blind expansion of enrollment will not help.
Will there be another “compromise”?
Although the doctors’ views have some basis in reality, critics believe that their opposition to enrollment expansion “is because they are worried about damaging their own economic interests.” According to reports, Korean doctors are currently among the highest paid groups of doctors in the world. Data from 2022 shows that the average annual income of specialists in South Korean public hospitals is nearly US$200,000.
It is worth noting that in the process of confrontation with the government, industry associations such as the Korean Medical Association played a very important role. Because more than 95% of hospitals in South Korea are private organizations, industry associations can easily unite practitioners. According to South Korean media, since 2000, doctors have organized multiple large-scale strikes against the government’s plans for division of labor, non-face-to-face diagnosis and treatment, and expansion of medical school enrollment, and each time the government backed down.
In July 2020, the then-ruling Moon Jae-in government proposed a plan to expand enrollment in medical schools, planning to expand enrollment by 400 students per year within 10 years. The expansion of this plan is only one-fifth of the latest expansion plan in early February this year, but it has met with fierce resistance from organizations such as the Doctors Association: within two months, 83.9% of resident doctors and 32.6% of specialist doctors refused to make visits. . Coupled with the factors of the new crown epidemic, the then government had no choice but to compromise, which became a major failure during Moon Jae-in’s administration.
But this time, the Yin Xiyue government obviously will not give in easily. First of all, the enrollment expansion plan is only part of the government’s package plan to reform local medical and basic medical care. Other plans include introducing a local contract doctor system, reducing criminal penalties for medical malpractice, and increasing investment in obstetrics and gynecology, pediatrics, and surgery. To a certain extent, it can also alleviate the problems raised by doctors; secondly, this reform plan has also won the consensus of all parties within the government, and even gained partial recognition within the medical community. The Korean Hospital Association has publicly endorsed the expansion; thirdly, medical reform also In line with the public sentiment, the social situation of an increasingly aging population has made the public feel the urgency of the shortage of doctors. According to the results of the polling agency, 76% of the respondents “positively evaluated” the enrollment expansion policy; finally, there is political need, and the Korean Congress election In the near future, since Yin Xiyue came to power, his diplomacy and economy have not been strong. He only wants to see whether he can seize the straw of medical reform. With no retreat, he can only continue to be tough.
Editor: Wu Jiahong
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2024-02-23 23:52:33