Is a breakthrough finally in sight in Korea's longest ever doctors' strike?

Nearly a year and a half after junior doctors resigned en masse and medical students boycotted their classes to protest the government's hike of the med school admissions quota, a breakthrough is in sight.

From left: Democratic Party (DP) Rep. Park Ju-min, Lee Sun-woo, interim leader of the Korean Medical Student Association, Kim Taek-woo, chief of the Korean Medical Association and DP Rep. Kim Young-ho deliver their joint statement on medical students' return to their schools in central Seoul on July 12. [NEWS1]

[NEWS ANALYSIS]

Nearly a year and a half after junior doctors resigned en masse and medical students boycotted their classes to protest the med school admissions quota hike, a breakthrough is in sight as the medical community and the new government are showing signs of compromise, signaling a step toward normalization of medical services and education.

On Saturday, the Korean Medical Student Association said medical students nationwide would return to their classrooms. The group vowed to work toward normalizing medical education, based on trust in the National Assembly and the government.

The announcement was the first position statement from the medical community since February last year, with the group promising a return to duties following Korea’s most protracted impasse between doctors and the government — a conflict President Lee Jae Myung, who took office last month, called “the most challenging issue” during a meeting with senior presidential secretaries earlier this month.

During a Cabinet meeting on Tuesday, Lee stated that the return of medical students to campus was “belated but fortunate." While instructing educational authorities to prepare measures for their return, Lee asked students to reflect on their “social responsibility for public health and lives” as aspiring medical professionals.

Throughout the 17-month-long standoff, the medical community and the government made little progress in bridging the gap between them. Both faced criticism for holding public lives and health hostage for their pursuits.

The 2,000-seat hike

Medical professionals walk inside a general hospital in downtown Seoul on Oct. 28 in 2024 [YONHAP]

On Feb. 6, 2024, then Health Minister Cho Kyoo-hong announced a plan to increase the admission quota from 3,058 seats to 5,058 seats starting from the 2025 academic year, marking the first such hike in 27 years. The expansion was part of former President Yoon Suk Yeol’s key medical reform initiative aimed at addressing physician shortages in essential medical fields and rural areas.

The Yoon administration backed its drive with a rationale that the country would need at least 15,000 additional doctors by 2035, considering the retirement ages of doctors and the rising healthcare demands from the aging population.

The quota hike triggered an intense backlash among medical students, junior doctors, private practitioners and medical professors. The medical community said the current quota was sufficient. They noted that physicians’ preference toward lucrative nonessential fields could change if labor conditions improved, with higher compensation and better legal protection for physicians performing high-risk surgeries and treatments.

Of 13,531 junior doctors nationwide, approximately 12,350 have walked out of their training hospitals since Feb. 20 of last year.

To dissuade junior doctors from protesting, the government issued “return-to-work” orders, threatening to revoke their medical licenses if they failed to comply. However, the medical community showed no signs of abatement.

A lecture hall at a medical school in northern Seoul is seen empty in March. [YONHAP]

Later, the government scaled back the quota increase to 1,509 seats for the 2025 academic year. The government exempted residents in their first year of training from taking written exams and allowed the striking junior doctors to return to their original positions without applying a rule that would have banned them from resuming their training.

Resignations filed by 9,198 junior doctors had been processed as of last November, according to the Health Ministry. As of May this year, 8,305 students from 40 medical schools nationwide had flunked, and 46 had been expelled.

In April this year, the government rolled back its admission quota hike and decided to admit 3,058 students starting in the 2026 academic year. It left the 2025 academic year as the sole one in which the increased number of students was accepted.

Patients and hospitals suffer

Paramedics and ambulance vehicles are seen in a general hospital in downtown Seoul in November. [YONHAP]

Medical services at training hospitals nationwide — mainly tertiary and general hospitals — were crippled following the collective walkout and resignations. Junior doctors used to account for around 40 percent of the physician work force in general hospitals on average.

The understaffed hospitals delayed surgeries and canceled outpatient appointments. The walkout also negatively impacted the availability of emergency medical services, resulting in the temporary closure of emergency rooms. Patients in critical condition had to travel long distances to find hospitals that could admit them.

In September, a woman in her 70s collapsed in Gumi, North Gyeongsang, but was rejected by over 10 hospitals. She was later admitted to a hospital in Changwon in South Gyeongsang and died the next day.

The Korea Alliance of Patient Organization — representing cancer and leukemia patients — said the collective action by doctors inflicted “critical damages” on patients. During their press conference in central Seoul on Monday, the group condemned doctors for using patients’ lives as a means to oppose the state health policies, calling their behaviors “unethical and inhumane.”

A medical professional walks by an emergency room in a general hospital in downtown Seoul in July 2024. [YONHAP]

Liberal Democratic Party (DP) Rep. Kim Yoon claimed that around 3,000 additional deaths occurred in the first six months of the protest as the patients failed to receive timely, appropriate treatment in hospitals. The data provided by the National Health Insurance Service showed that the mortality rate based on hospitalized patients remained at 0.81 percent between 2015 and 2023. The figure rose to 1.01 percent last year.

However, the medical sphere refuted Kim’s claim. Prof. Jung Jae-hun from Korea University’s College of Medicine, who tracked the number of deaths during the protest, said his analysis found no verifiable correlation.

When it comes to hospitals, service downsizing translated into mounting deficits.

The Health Ministry stated that five major general hospitals reported a business surplus of 11.1 billion won ($7.9 million) in 2023, before the doctors’ strike. However, last year, their combined deficit exceeded 200 billion won. Seoul National University Hospital posted a deficit of 110.6 billion won. Samsung Medical Center recorded a deficit of 52.5 billion won. Yonsei University’s Severance Hospital followed with a deficit of 44.7 billion won.

New leadership, changing tides

Lim Hyun-taek leaves the Korean Medical Association's headquarters in Yongsan District in central Seoul after the organization passed a motion to impeach him from the chief position in November. [YONHAP]

Although doctors maintained their firm stance against the government, internal strife surfaced during the protest.

In November, Lim Hyun-taek, then-chief of the Korean Medical Association (KMA), was impeached due to his defamatory remarks and for allegedly soliciting money from another doctor. The KMA is the nation’s largest doctors’ group. Lim received criticism in June last year after unilaterally announcing hospital shutdowns as a form of protest without any prior consultation with other doctors.

Even after Lim’s ouster, the KMA continued to maintain its animosity toward the Yoon administration.

Following the Constitutional Court’s ruling to uphold Yoon’s impeachment, the KMA issued a statement that likened Yoon’s ouster to “the skies beginning to clear.” The KMA also accused Yoon of destroying the medical system by railroading misleading health policies.

When Lee Jae Myung — who led the liberal Democratic Party during Yoon’s presidency — won in the June 3 presidential race, the KMA congratulated him. It also asked him to prioritize resolving the medical crisis and improving the training environment for young doctors.

Park Dan, former chief of the Korean Intern Residents Association, speaks during a parliamentary seminar at the National Assembly in western Seoul on March 10. [NEWS1]

Junior doctors also saw their leadership change.

On June 24, Park Dan, a hard-liner who had led the Korean Intern Residents Association (KIRA) since August 2023, stepped down after junior doctors’ voices calling for a return grew. Some junior doctors criticized him for being passive in ending the conflict. Even a day before his resignation, Park said that “it is unnecessary to decide on return immediately.”

Two days after Park’s resignation, Han Seong-jon — seen as a moderate — was elected as the new KIRA leader. Han urged junior doctors to make a “realistic judgment,” calling the current moment an “optimal time” to restore the crippled medical system with a “fresh start.” His remarks seemed to indicate a shift from the previous unconditional protest.

On Monday evening, Han met with lawmakers at the National Assembly. Although the potential timeline for a return by junior doctors was not discussed, parliamentarians and the representative of junior doctors agreed to keep discussing means to solve the impasse for the public and patients, according to the office of DP Rep. Park Ju-min.

Democratic Party Rep. Park Ju-min, left, who chairs the parliamentary health committee, talks with Han Seong-jon, leader of the Korean Intern Resident Association, during their meeting at the National Assembly in western Seoul on July 14. [NEWS1]

The country also elected its new president.

President Lee ordered Prime Minister Kim Min-seok to take active measures to resolve the impasse on July 7, the first day of Kim's term. On the same day, Kim held a meeting with representatives from the KMA, KIRA and medical student groups. Five days after Kim’s meeting, medical students announced their return to campuses, bringing an end to their three-semester-long boycott.

On Tuesday, the KMA issued a statement in which it expressed its deep agreement with Lee's recent remarks in the Cabinet meeting — an order to review the medical vacuum and prepare follow-up measures. The doctors' group also promised to actively cooperate in designing effective state health care policies.

No quick fix

Doctors protest against the government-led medical recruitment quota hike during a rally held in western Seoul in June 2024. [YONHAP]

Although full-scale medical education is set to resume for the first time in 17 months, several issues remain.

There are lingering concerns about how to prevent doctors from taking similar collective actions that disrupt medical services and harm patients.

In the presidential race earlier this year, President Lee also pledged to establish "public medical schools."

KMA chief Kim Taek-woo said a public medical school "without verifying education quality and training system could harm public health in the long term" during an interview with News1 on Monday. His remarks appeared to suggest that the doctors' group and Lee's proposed health care policy might be on different pages.

Medical students of Pusan National University attend an explanatory session for the 2025 academic year held on their campus in Busan on July 14. [PUSAN NATIONAL UNIVERSITY]

Medical schools are scrambling for solutions to accommodate last year’s and this year’s first-year students together, which is likely to double their occupancy.

A staffer from Pusan National University’s College of Medicine told the Korea JoongAng Daily on Wednesday that the school is taking measures to open classes during the summer and winter breaks to help students fulfill their academic requirements. The university reportedly has some 600 medical students who were held back.

“The school is currently preparing to run summer-season classes flexibly,” the official said. “Once a decision to open classes is made, the school will receive applications without any delay.”

A faculty member from Chonnam National University's medical school also told the newspaper that the school is "currently devising measures" on how to carry out its curriculum for the returning students.

BY LEE SOO-JUNG [lee.soojung1@joongang.co.kr]