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A staff member at a major hospital in Seoul heads into a research ward for professors on March 15, 2024. (Yonhap)

Nearly a month has passed since South Korean interns and residents collectively submitted their resignations to protest a planned increase in the nationwide medical college admission cap.

While patients continue to suffer the consequences — with tertiary hospitals performing operations at just half their regular rate — the conflict just continues to grow without any sign of dialogue between the administration and physicians.

This has prompted increasingly vocal calls for both sides to set aside their conditions and begin having dialogue before the lengthening health care vacuum inflicts even greater harm on patients.
 
Tense tug-of-war

In an emergency press conference Sunday, National Medical Center head Joo Young-soo said, “The threat to patients’ health and lives from the current collective action by interns and residents has reached serious proportions.”

“We earnestly entreat the interns and residents to return to their patients quickly,” he added. His remarks were a critical reaction to a statement Friday by the medical center’s specialist association, which said it would “not sit idly by as interns and residents are subjected to disadvantageous treatment.”

Joo was among many in the medical world calling for interns and residents to return to the job. Meanwhile, the conflict has persisted. Even the medical college faculty members who discussed the possibility of dialogue also stressed that protecting their students came first.

In a press conference Sunday, Bang Jae-seung, the chairperson of an emergency committee representing national medical college faculty, said that “16 universities have overwhelmingly approved the submission of resignations” starting on March 25.

Bang also sent a message calling on the administration to change its approach.

“Discussions themselves cannot take place unless something is done about the ‘2,000 students’ number,” he said, referring to the figure by which the administration has set its plan for increasing medical school admissions.

Joo said it was “disappointing to hear this kind of talk from medical college professors, who stand at the pinnacle of the physician profession.”

“I think this is extremely inappropriate in a situation where the entire nation is watching [the medical world],” he added.

Interns and residents have been pursuing their collective action without any representative organization.

The Korean Intern Resident Association (KIRA) has been refusing to engage in dialogue with the government or even the heads of teaching hospitals ever since its executive board resigned and the association switched to an emergency committee system before the submission of en masse resignation letters on Feb. 19.
 
The government remains adamant on pushing through its increase of the medical school admissions cap.
 
“Professors are challenging the rule of law when they say that they won’t let any punishment against their students slide,” said Park Min-soo, the second vice health minister, appearing on a YTN news program. 

“Professors should do more than ask the government to reduce the intended medical admissions increase of 2,000 people. They should ask medical residents and interns to return immediately to their work stations, and navigate their way through a situation in which patients’ lives are at stake,” he added. 
 
Park also used the opportunity to remind residents and interns who have deserted the field that major hospitals are suffering losses of 1 billion to 2 billion won a day. “If civil lawsuits are put on the table, medical residents and interns will have to shoulder a considerable burden,” he warned.
 
Clashes between physicians and the government have been ensuing for a month now, with no end in sight as both sides dig in their heels. The situation is even worse than that of 2020, when physicians refused to work in protest of the Moon Jae-in administration’s attempt to increase the medical school admissions quota.
 
At the time, associations such as the Korean Medical Association and KIRA were active and open to negotiations with the government and various political parties. Now, the medical community lacks such associations to lead dialogue, while the government lacks any kind of incentive, merely asking that the physicians form associations. Political parties, who are staring down the upcoming general election on April 10, have also opted to remain silent, declining to make any moves to resolve the conflict.
 
Please, come to the table
 
As the conflict grows protracted, a ballooning number of patients are left dealing with the consequences. If medical professors follow the lead of medical residents and interns and also abandon patient care, Korea will face a health care disaster, as treatment of emergency patients and those in critical care will be impossible without professors to provide outpatient care and perform surgeries.
 
“The government may claim that the emergency health care system is stable, but many surgeries, such as non-emergency cancer surgeries, have been put on hold,” explained Jeong Hyeong-jun, who oversees policy issues at the Association of Physicians for Humanism. “Many professors are on the verge of burnout due to the hefty amount of work they have had to shoulder since the departure of medical residents and interns. If professors also resign, a health care crisis will be unavoidable.”
 
As such, many within the medical field and elsewhere are calling for groups to at least sit down at the negotiation table.
 
Some observers argue that the administration should take responsibility for mediating conflicts that have arisen in its attempts to implement its policy, that medical residents and interns should return to their workstations and then criticize the government’s policies, and that professors should try to bridge the gap in opinion between the two sides.

“Health care does not only concern the government and physicians, but also the welfare of patients. As the clash between the government and medical residents and interns has dragged on for over a month and concerns about the welfare of patients are growing, it is time to start discussions to resolve the conflict,” commented Han Hee-chul, the deputy head of the National Academy of Medicine of Korea. 
 
Incheon Medical Center’s Director Jo Seung-yeon remarked, “If patients continue to be denied care, even if the arguments made by medical residents and interns are taken into consideration, those groups may have to face major legal liabilities for harms experienced by patients. Professors, as senior physicians, should look out for medical residents and interns by helping them get back to work, rather than joining them in their collective action.”
 
Associations concerned with the welfare of patients are also eager to get the ball rolling on dialogue. 

“As of now, the government and physicians are refusing to look each other in the eye while loudly shouting their own claims. In a situation where the suffering of patients is becoming exacerbated, they need to sit down at the negotiation table with no strings attached,” said Kim Seong-joo, the head of a confederation of associations concerned with serious illnesses. 
 
Shifting public opinion
 
The way that the general public views the conflict between the government and physicians is also changing. According to a survey released by Gallup Korea on Friday, 49% of respondents stated that the government is “dealing poorly with” the issue of the increase in medical school admissions, which is 11 percentage points higher than those who think that the government is responding adequately (38%).
 
While the week before, many cited the increase in the medical school admissions quota as the biggest reason for supporting President Yoon Suk-yeol, whose approval rating was at 36%, the percentage of those who still believe that has decreased.
 
Kim Eun-jeong, the joint secretary-general of the People’s Solidarity for Participatory Democracy, commented, “The public is feeling fatigued now that patients have been directly impacted by this situation. Hard-line approaches to this issue are not what our society needs right now.”
 
“Creating a forum for discussion that involves the government, physicians, and the public would be a way to overcome the current situation,” she added.

By Cheon Ho-sung, staff reporter; Kim Yoon-ju, staff reporter

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