Why are South Korean trainee doctors on strike?

SEOUL - South Korean hospitals were thrown into chaos this week as thousands of trainee doctors downed tools to protest medical training reforms aimed at ending a shortage of medics.

Patients were left in limbo with crucial treatments cancelled as the trainee doctors faced off against South Korea's government, which has vowed not to back down over the "necessary" reforms.

AFP takes a look at what we know:

What reforms?

In the largest shake-up to the country's medical training system in years, Seoul announced it would sharply increase -- by 65 percent or some 2,000 extra people a year -- the number of students admitted to medical schools from 2025.

Officials say the reforms are essential to prepare to care for an ageing population and create enough doctors to ease current shortages -- South Korea has just 2.6 doctors per 1,000 people, far below the average of 3.7 among the 37 developed nations, OECD data shows.

As a result of their relative scarcity, Korean doctors are some of the best-paid in the OECD, the data shows, and significantly out-earn the South Korean national average.

They are also held in high social regard in the education-obsessed nation, as getting into medical school requires acing the all-important college entrance exam.

Will it help?

Doctors say the government reform plan ignores the field's real issues.

A shortage of specialists in certain key areas, such as paediatrics and cardiology, is due to misplaced financial incentives from the national health insurance and the risk of medical lawsuits.

For example, in 2023, a huge number of junior doctors applied to specialise in mental health, ophthalmology and cosmetic surgery, but there were huge shortfalls in other areas such as cardiothoracic surgery.

Increasing the overall number of doctors will not help unless the government fixes "essential issues like low medical service pay and frivolous lawsuits", said the Korean Intern Resident Association, the body leading the strike, in a statement.

The government should come up with measures to "reduce legal burden" in case of "uncontrollable medical accidents", they said.

But Kim Jae-heon, the secretary general of an NGO advocating free medical care, told AFP the doctors' position was not popular.

"Opposing the expansion of medical school admissions to ensure greater profitability by reducing competition when they establish their own practices in the future is unlikely to garner public support," Kim said.

What about patients?

South Korea's five major hospitals have cut surgeries by up to 50 percent to cope with the work stoppage, the Yonhap news agency reported, citing medical industry sources.

Online communities were flooded with posts about receiving phone calls from hospitals.

"I was scheduled to have my brain tumour surgery next Tuesday but was notified it wouldn't be possible due to the resignation of trainee doctors," one patient wrote, adding: "I'm very upset. Is it okay for a doctor to hold the patient hostage?"

Another patient lamented having her breast cancer operation postponed indefinitely only two days before the surgery.

"I'm really angry at both the government and the hospital," she wrote.

"I hate both the government that created this situation and the doctors who pretend not to know that no cause is more important than their patients."

So it's demographics?

South Korea is on track to be a so-called super-aged society by 2025, meaning a fifth of the population will be aged 65 years and over. By 2050, this share could be 44 percent.

Officials say that unless they act now, doctors will be "overwhelmed with dramatically increased demand" down the road.

By 2035, the country could face a shortfall of some 15,000 doctors, if the current medical school admissions policies are not changed, the government says.

South Korea also has one of the lowest birth rates in the world -- 0.7 births per woman -- far below the replacement rate, meaning the population is ageing and shrinking rapidly.

And the politics?

Previous South Korean governments have attempted to increase medical school enrolments, with a 2020 attempt derailed by a large-scale trainee doctors' strike at the time.

But public opinion was more favourable to the doctors at the time, with medical workers receiving widespread praise for their handling of the Covid-19 pandemic.

Now, in contrast, polls suggest up to 75 percent of the public supports the reforms, fed up with long wait times for essential procedures.

Some analysts say Yoon Suk Yeol's conservative government is looking to harness the issue ahead of April elections, when his party hopes to regain a parliamentary majority for the first time since 2016.

"I think that the current regime will attempt to use these doctors' protests to divert the popular attention from the issues which are much less advantageous for the ruling camp," Vladimir Tikhonov, professor of Korean studies at the University of Oslo, told AFP. - AFP