Trainee doctor exodus pushes South Korea’s collapsing healthcare system to the brink

Disillusioned trainee doctors have abandoned hospitals in their thousands, leaving critical services in shambles and patients turned away

South Korea

Park Chan-kyong

Published: 8:00am, 27 Aug 2024

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Corrected [9:26am, 27 Aug, 2024]

[9:26am, 27 Aug, 2024]
An earlier version of this article incorrectly identified South Korean politician Ahn Cheol-soo as Ahn Chul-woo. This has been corrected.

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South Korea’s healthcare system is unravelling at an alarming rate, the result of a months-long strike by thousands of trainee doctors who have walked off the job in protest, abandoning accident and emergency departments – and forcing hospitals to scale back critical services.

The consequences have been catastrophic. Across the nation, patients are being turned away from overstretched, understaffed A&Es, with some large hospitals suspending treatment for cardiac arrests and traumatic injuries. It’s a crisis compounded by a resurgence in Covid-19 cases, pushing the system to the brink.

“My current situation here shows how the emergency care system is collapsing,” said Namgung In, an emergency medicine doctor in Seoul. He described having to turn away a traffic-accident victim with serious injuries who had already been refused treatment by multiple hospitals.

The strike began in February, sparked by the government’s decision to significantly increase annual medical school admission quotas – a move the country’s 13,000 trainee doctors saw as a threat to their wages and job prospects. In a dramatic act of defiance, most resigned en masse, abandoning hospitals that had grown dependent on their labour to prop up an ailing system hobbled by low reimbursements.

“I am sorry, sir. We will never come back,” one disillusioned trainee doctor wrote on Sunday to Hwang Gyu-suk, the head of the Seoul Medical Association, in a letter seen by This Week in Asia.

Since quitting, the doctor said he had taken on odd jobs as a chauffeur and orchard worker to make ends meet.

03:04

South Korean patients suffer as healthcare system in turmoil amid doctor protest

The fallout of the mass exodus is reverberating across South Korea, with hospitals slashing services and cancelling procedures as they struggle to keep the lights on. Authorities insist the restrictions are “temporary” and promise increased fees to discourage non-urgent visits. But for patients in need of critical care, the consequences could be dire – a sobering glimpse of a healthcare system in free fall.

The government’s move to expand medical school quotas temporarily boosted Yoon’s approval ratings earlier this year, as the conservative president sought to project an image of determination and commitment to reform.

But the ill-advised gambit has now come back to haunt him, with the mass exodus of trainee doctors dealing a significant blow to the ruling party in recent elections.

“Trainee doctors say, first of all, their pride and honour have been trampled upon,” Hwang told This Week in Asia, referring to the government’s characterisation of young doctors as “selfish” and the suspension of their licenses in a heavy-handed attempt to force them back to work.

The underlying issue, critics argue, is that compensation from the state healthcare system remains woefully inadequate, particularly in difficult but essential fields like paediatrics, emergency medicine, and neurosurgery. As a result, many doctors have gravitated towards more lucrative specialities such as plastic surgery, leaving vital areas critically understaffed.

Medical staff walk past an ambulance parked outside a hospital in Seoul. Photo: AFP

In a misguided bid to address these shortages, especially in remote regions, the government had sought to simply increase the overall supply of doctors, banking on a “trickle-down” effect that would encourage more to enter the less popular but crucial fields. This has led to trainee doctors in those specialities referring to themselves as the “trickled-down physicians”.

The consequences of the systemic collapse can be seen in the plight of veteran politician Kim Jong-in, who revealed last week that he was turned away by 22 hospitals after suffering a severe gash on his forehead.

“The crisis could cause serious damage to the healthcare system. If this system collapses, it would be difficult for the ruling party to maintain its hold on power,” the 84-year-old economist and politician told Seul’s CBS radio.

Kim openly questioned whether President Yoon Suk-yeol truly understood the complexities of medical issues when he had “pushed through with the decision” to dramatically increase the annual medical college admission quota by 60 per cent to over 5,000, set to take effect next year. The president had cited the disputed “shortage of doctors” as justification for the controversial move.

To end the medical crisis, the government must first admit its mistakes

Ahn Cheol-soo, doctor and PPP member

Even members of Yoon’s ruling People Power Party (PPP) have expressed grave concerns over the administration’s botched handling of the crisis.

“To end the medical crisis, the government must first admit its mistakes,” Ahn Cheol-soo, a medical doctor and IT expert affiliated with the PPP, wrote on his Facebook page last week. Ahn warned that the situation would only deteriorate further as the resurgence of Covid-19 compounds the ongoing doctors’ strike.

His party colleague, former lawmaker Yoo Seung-min, echoed these concerns, stating in a social media post on Saturday that “nothing is more urgent than resolving the current medical crisis”. Yoo excoriated the government’s failed strategy of simply increasing medical school quotas, noting ruefully that more than 10,000 future specialists had “disappeared” as a result of the trainee doctors’ mass exodus.

“The government increased the annual quota of medical schools by 2,000 to more than 5,000 to bolster vital medical care,” he said. “But the essential and emergency medical care that the government promised to save is rapidly collapsing.”

Ultimately, the message was clear: Yoon must take decisive action to address the crisis, or risk the consequences of a healthcare system pushed to the brink of collapse – and the potentially devastating political fallout that could follow.