A nurse walks into the resuscitation area at an emergency room at the Catholic University of Korea Uijeongbu St. Mary’s Hospital after junior doctors walked out of hospitals in a collective action against the government's plan for a medical enrollment hike. (Yonhap)
Amid intensifying tensions between doctors and the government over its plan to increase the medical school enrollment quota, the government has upped the pressure, issuing doctors with an ultimatum to return to work by Thursday.
The government will not hold medical residents accountable for walking out if they return to work by the deadline, according to Interior and Safety Minister Lee Sang-min, who spoke at a briefing Monday. Previously, the government has warned of a possible suspension or revocation of medical licenses and even prosecution if doctors and medical residents do not return to work.
President Yoon Suk Yeol also stressed the same day that it is the state's constitutional responsibility to provide timely and proper medical treatment to those who are sick, highlighting the vacuum created by the doctors who walked out of hospitals.
As of Friday 7 p.m., more than 10,000 junior doctors, or 80.5 percent of the country's total, have handed in resignation letters at 100 training hospitals, while 9,006 of them stayed off work. Walkouts of medical staff have continued for seven consecutive days leading to major general hospitals in Seoul having reduced planned surgeries by up to 50 percent, sparking a serious health crisis in the country.
The government also warned that trainee doctors who refused to return to work by Thursday could start facing legal consequences.
"Starting in March, the suspension of doctors' licenses for a minimum of three months will become unavoidable for those who fail to return under the law, along with judicial measures, such as investigations and prosecutions," Second Vice Health Minister Park Min-soo said at Monday's briefing.
"It should be noted that a license suspension creates a record that may impact future career paths, including opportunities for employment abroad," he added.
Once the counting of doctors who refused to return is complete, the Health Ministry is expected to file a complaint to the police. The police can then immediately issue a summons to the accused and initiate a formal investigation. The government noted that failure to comply with the order to resume work could lead to charges of violating health care laws.
Meanwhile, the police have initiated investigations on key officials of the Korea Medical Association and the Korean Intern Resident Association after a civic group filed a complaint last Wednesday on eight charges of violation of medical laws.
In an apparent move to add pressure on striking doctors, the government also said male junior doctors will have to serve 38 months as medical officers starting in March 2025 if their resignations are accepted.
According to South Korea's Military Service Act, those who have been classified as a medical cadet at their request must apply on the nearest date of enlistment if one has changed or resigned from training institutions without the permission of the Military Manpower Administration.
Considering that the Ministry of Defense classifies medical cadets for enlistment in February each year, and that enlistment as a medical officer or public health doctor takes place in March of the same year, doctors resigning now would have to enlist in March next year.
However, the administration will not immediately decide whether the doctors will be enlisted right away as the Health Ministry has issued an injunction against accepting collective resignations.
Amid a growing medical gap across the country, a cardiac arrest patient in her 80s in Daejeon died over the weekend after being refused admission to the emergency room by seven hospitals, due to a lack of beds, an absence of specialists and medical staff, and an inability to treat critically ill patients.
The number of incidents where patients have difficulties finding hospitals is mounting, with patients waiting more than three hours and even waiting around outside of hospitals to be treated. A total of 227 cases of harm caused by the suspension of hospital operations were officially reported to the Health Ministry hotline as of Friday, of which 171 cases were related to delays in surgery.
To combat the shortage of doctors, the government will conduct a pilot project for Physician Assistant nurses working in general hospitals and training hospitals nationwide starting Tuesday. This will allow heads of each health care organization to determine the scope of work nurses can perform.
PAs are nurses who can partly take over the duties of doctors in medical institutions and have been called clinical nurse specialists or operating room nurses. Well institutionalized in the United States, the roles of such nurses are not stipulated in the Korean medical law system, having been used as a practice at the individual hospital level since the early 2000s. It is estimated that there are more than 10,000 PAs in the country.
Although PA nurse training has been discussed as a solution to the growing shortage of doctors, the Korean Medical Association has opposed institutionalization, as it would require redefining the scope of licenses for doctors and nurses.
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