The South Korean government on Monday said that it was moving to suspend the licenses of thousands of doctors who walked off the job nearly two weeks ago, threatening to escalate a dispute that has shaken the nation’s health care system.
The announcement came after thousands of physicians, nurses and medical professionals took to the streets on Sunday, rallying with banners that read: “Doctors are not criminals!
For more than a month, young doctors have been in a high-stakes dispute with the government over the future of health care in the country. Nearly 10,000 interns and residents, about a tenth of all doctors in the nation, have walked off the job, with most ignoring a Thursday deadline to return to work. On Monday, the government said it would begin to suspend the licenses of around 7,000 of those doctors.
But two weeks after the walkout, it remains unclear how the disagreement will be resolved.
“Why would we want to go back after the government has treated us like the bad guys and has not addressed our demands?” said Lee Haeju, 32, who until recently was a resident at Seoul National University Bundang Hospital.
Dr. Lee — who said that she was so sleep deprived during her first year of residency that she felt like she operated on a 48-hour cycle instead of 24 — and her cohort have long complained about the pressures they face.
They say some of them do not even make minimum wage, their work conditions are Dickensian and that they are overburdened by complaints from litigation-happy patients. The authorities, they say, have long ignored systemic issues that made specializations like dermatology and cosmetic surgery more lucrative than essential services like emergency care.
Last month, the government issued a new health care policy that it said would address a longstanding shortage of doctors by increasing medical school admissions by about 65 percent a year. But interns and residents, known as trainee doctors, said the government was continuing to ignore the real issues facing doctors.
“How many people would actually work in our department?” said Dr. Lee, who specializes in thoracic and cardiovascular surgery.
Surveys show widespread public support for increasing medical school admissions, the quota for which was last raised in 2006. The government points to statistics that show South Korea has one of the fewest doctors per capita in the developed world. And it says that increasing the number of doctors is crucial in a country with a rapidly aging society.
Facing legal threats, hundreds of trainee doctors have returned to work, but the vast majority of them continue to protest.
The orders were issued to “prevent serious hazards posed by the collective actions of trainee doctors,” Cho Kyoo-hong, the health minister, said in a written reply to questions.
Under South Korean law, the government can force some doctors back to work to avoid a disruption of care. Violators may face a fine of up to 30 million won ($22,000) or jail time of up to three years.
For now, patients have been directed to smaller hospitals and clinics. Major hospitals have had up to half of their operations delayed, and nurses have been allowed to assume some of the duties of doctors. The government has opened military hospitals and increased operating times for public clinics, and while there have been disruptions, the health system has not buckled.
Trainee doctors are a crucial cog in the medical system in South Korea. In major hospitals, they often make up a third of staff and often are the first caregivers to attend to patients.
Park Dan, 33, said he wanted to be an emergency room doctor to save lives. As a resident at Severance Hospital in Seoul, one of South Korea’s biggest hospitals, he said he worked 100-hour weeks, often saw 20 patients every 60 minutes, and had to hold off going to the bathroom for hours on end.
“I thought my own life might be cut short in my effort to save others,” said Mr. Park, who is also the head of the Korean Intern Resident Association.
South Korea has a universal health care system that provides care for all citizens. But doctors argue that the government has underinvested in essential services, making specializations like emergency care and pediatrics less financially appealing to physicians. The government has said it would spend about 10 trillion won, or $7.5 billion, on essential health services over the next five years.
Early-career doctors in South Korea typically work longer weeks and earn less than their counterparts in the United States. Interns and residents make about $3,000 a month, which is less than minimum wage, considering their long workweeks, according to Lee Jaehee, a lawyer who is representing some of the doctors who have walked out. Their shifts cap out at 36 hours, and their workweek can stretch to 88 hours.
For trainee doctors, the situation is “similar to the Industrial Revolution when young boys and girls were forced to work in factories,” said Dr. Lim Hyun Taek, the president of the Korean Pediatric Association.
This is not the first time doctors have protested a government plan to increase the medical school admissions quota. In 2020, a monthlong strike by doctors forced the authorities to shelve a similar plan. But this time, the government has so far remained steadfast in its position and criticism, arguing that the walkout has compromised the health and safety of the public.
The doctors reject that notion.
“We’ve cried with patients and have held their hands along the way to their recovery,” Dr. Lee said. “We’re not criminals.”