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[Editorial] Young doctors at crossroads

Medical professors expected to mediate between their students, government

Feb. 28, 2024 - 05:28 By Korea Herald

Some 80.6 percent of the nation’s trainee doctors have tendered their resignation, and 72.7 percent, or about 9,000, have left the hospitals in protest of the government’s plan to increase the number of places at medical schools. The worsening shortage of interns and residents for over a week at emergency rooms and operating rooms has led to delays in surgeries and emergency treatments as well as severe fatigue of the remaining medical staff.

The Ministry of Health and Welfare on Tuesday filed a complaint with the police against five former and incumbent members of the executive department of the Korea Medical Association for instigating and abetting collective action by interns and residents.

The government has given trainee doctors until Thursday to return to work, warning that those who continue to refuse to treat patients will be subject to police investigations and indictments.

From March, a suspension of the medical license for at least three months as well as probes and indictments will be “inevitable” for those who have not returned to work, Health and Welfare Minister Cho Kyoo-hong said.

“(The government) will respond to illegal collective actions according to the law and principle,” he said.

“Trainee doctors who have left their workplaces are once again asked to return by Feb. 29. If they come back by Thursday, they won’t be held responsible (for having walked out).”

To woo doctors, the ministry said it would speed up legislation on special cases that exempts insured medical staff from prosecution for medical accidents.

Through such legislation, similar examples of which cannot be found in other countries, the ministry expects that patients will be promptly and sufficiently compensated for damage, and medical staff can focus on treating patients, Cho said.

As nurses have been filling in for the interns and residents that have left, a pilot program went into effect Tuesday to provide nurses legal protection by having the chiefs of medical institutions determine the scope of work that can be performed by nurses. There are, however, medical procedures that nurses cannot perform, as per judicial precedents.

Nurses in operating rooms known as PA (Physician Assistant) nurses are currently doing many of the jobs of junior doctors, such as checking for infections or bleeding after surgeries. In hospitals outside the greater Seoul area, it has been a long time since specialties such as obstetrics and gynecology, pediatrics and urology had any residents at all, and the number of PA nurses has been rising nationwide.

Medical college professors at Seoul National University have called on the government to hold regular talks with medical college professors on policies to alleviate the dearth of doctors in essential health care. To get the residents to return to work, persuasion is necessary, not threats or coercion, they said. University presidents who have overstated the number of medical students they need to admit, and those who reported those hopeful numbers to President Yoon Suk Yeol should be reprimanded, SNU professors said.

The figures reported to the ministry in November, the total of which came to at least 2,151, mostly reflected the hopes of the universities, rather than the medical colleges. Deans of 40 medical colleges and schools have officially asked the Education Ministry to push back its March 4 deadline for the schools’ quota increase applications. The ministry has stated, however, that the deadline cannot be altered.

Professors and nurses in areas of essential health care are working 160 hours nonstop to make sure no patient in critical condition is left untreated. But they can’t keep going like this for weeks. Interns and residents should be more open to talks with their professors, some of whom are expected to serve as mediators between the junior doctors and the government. It is widely known that South Korea's trainee doctors are overworked and underpaid compared to those in advanced countries. This can be their golden chance to improve their working conditions by talking with the government which has pledged to spend 10 trillion won over the next five years to resuscitate areas of essential health care such as pediatrics, emergency medicine, general surgery, cardiothoracic surgery and obstetrics. A prolonged strike would only cause their bargaining power to diminish.