The junior doctors, who have resigned en masse in protest of the government plan to increase the number of medical students, remain suspicious of Yoon’s sincerity about talks, considering his resolute determination expressed in previous speeches.

On Wednesday, the presidential office reaffirmed Yoon’s stance announced the previous evening that he wants to discuss the issue with the junior doctors, who are directly engaged in the collective action, and hear what they have to say. The office said it is waiting for the Korean Intern Resident Association (KIRA) to answer Yoon’s invitation. An official said that the talks can take place at any time, about any topics that trainee doctors want.

This came after a spokesperson of the Medical Professors Association of Korea asked KIRA head Park Dan to meet Yoon without any conditions, during an online press briefing on Tuesday. Prime Minister Han Duck-soo also said on the day during a TV appearance, “Yoon has a very strong intention for candid talks with them with no limits on subjects.”

Yoon brought up holding a discussion about the 2,000 new slots to be added to the current quota of 3,058 came on Monday during a 51-minute televised address to the nation, urging doctors to propose a unified and rational plan.

While the presidential office stressed his speech was intended to show that the government is open to backing down on the existing plan, the message ended up drawing negative responses from doctors because Yoon devoted most of his speech to rattling off research results on the anticipated shortage of medical doctors in the country and criticizing doctors for the prolonged walkout.

The KMA said in a press briefing on Wednesday that it welcomed Yoon’s approach to meet junior doctors, but stated that it is “difficult to verify the intention” behind the government’s suggestion for talks, and added that “the most viable way of guaranteeing the sincerity of the talks is suspending the expansion in next year’s medical school quota.”

While various medical associations are voicing their own opinions, KIRA, which holds the key to ending the walkout, has not responded to the government.

Since March 29, KIRA has not been releasing any statements on the issue, with its head Park refusing to respond to media inquiries on Yoon’s invitation.

Skepticism is growing that a meeting between Yoon and Park would not likely bring an immediate resolution to the medical standoff.

“It is still confusing whether the government has the intention of stepping back from the 2,000 (added) slots,” a medical professor based in Seoul said on condition of anonymity.

“With Yoon stressing the importance of the 2,000 slots throughout his speech, how could anyone believe that the government will compromise on its plan? To enable talks, the government should start by suspending the current policy. Otherwise, the dialogue, even if it takes place, will end up being used for political grandstanding before the general elections.”

Even if Yoon meets the KIRA head, chances are slim for an immediate rollback in the policy, because the government has already finished distributing the increased slots to medical schools across the country, and universities are now setting up requirements for next year’s admissions, with their deadline set for April 30.

Since any abrupt changes would cause confusion in college admissions and a backlash from students and parents, a presidential official told reporters that any big changes from the 2,000 slots would be difficult, and doctors should consider this when they come up with their unified plan.

Difficulties in unifying doctors are also raising skepticism.

Though the KMA is the biggest doctors’ association, KIRA, the professors’ association, the Korean Medical Student Association and other doctors’ groups hold slightly different positions on how to counter the government’s push, with doctors saying the KMA does not represent all of them.

A KMA spokesperson told reporters Wednesday that it is communicating with trainee doctors, but was unavailable to share details on the proposed talks, citing that it is a matter between the presidential office and trainee doctors.

Adding to this, many trainee doctors are now refraining from engaging in collective actions after the government threatened to suspend their licenses and take other legal actions in response to their walkout.

“Trainee doctors are now scattered to avoid the government’s threats, and it is hard to say there is an entity that can play a pivotal role for drawing a unified doctors’ proposal,” the Seoul-based professor said.

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Nearly 100 general hospitals have canceled or postponed nonessential procedures and turned away non-emergency patients, prioritizing service for severe emergency cases to minimize the growing strain on the medical system.

As of Thursday night, 8,897, or 78.5 percent, of the 13,000 trainee doctors from 96 major teaching hospitals in Seoul and elsewhere have submitted their resignations, with 7,863 of them not reporting for work, according to the health ministry.

More junior doctors are expected to join the protest, raising concerns as they play a vital role in assisting with surgeries and emergency services.

One hospital, Chungnam National University Hospital, located in the central city of Daejeon, turned away some patients seeking emergency care Saturday due to a limited number of available physicians to handle urgent cases, such as cardiac arrest.

“A grandmother came to the emergency room alone this morning, but (the hospital) says it can only accommodate critical patients, making treatment impossible,” said a paramedic, noting that the patient would be transported to a smaller hospital nearby.

Hospitals have struggled to maintain their operations by enlisting the help of doctors in fellowship programs, professors and nurses to fill the void.

Since raising its four-scale healthcare service crisis gauge to the highest level of “serious” from “cautious,” the government has also advised patients with mild symptoms to utilize nearby clinics instead of general hospitals.

Furthermore, the government has temporarily extended telemedicine services, such as consultations and prescriptions, at all hospitals and clinics until the end of the walkout.

The telemedicine services had been partially available since 2020 in the wake of the COVID-19 pandemic under strict regulations.

Additionally, military hospitals nationwide have fully opened their emergency rooms to the public since Tuesday to address public health concerns over emergency services.

According to the defense ministry, a total of 32 civilians had received treatment at military hospitals as of noon Saturday.

Doctors and medical students have voiced opposition to the government’s plan to admit 2,000 more students to medical schools next year from the current 3,058 seats to address a shortage of doctors.

The government plans to remedy a shortfall of 15,000 physicians expected by 2035.

The Korean Medical Association (KMA), a main lobby group for doctors, argues that there are already sufficient physicians and that simply increasing the quota of medical students would lead to unnecessary medical costs.

Furthermore, the KMA argues that the plan fails to address issues, such as overburdening and the lack of incentives for doctors who specialize in essential health care services, including pediatrics, obstetrics and emergency medicine.

In contrast, the government said that the country should begin training more new doctors to address the challenges posed by a rapidly aging society, citing examples of other major developed countries facing shortages of physicians.

The number of doctors in South Korea relative to the size of the population is among the lowest in the developed world, according to health authorities.

Despite authorities repeatedly warning of police investigations or even arrests of physicians participating in the walkout in the case of patient deaths, the KMA plans to hold large-scale rallies in Seoul on Sunday and March 3.

In a statement released late Saturday, the Medical Professors Association of Korea said it will make utmost efforts to help resolve the current medical crisis and serve as arbitrator in the disputes between the government and the doctors’ group for a breakthrough.

On Friday, the government raised its health alert to “severe” from “cautious” after emergency departments at major hospitals have been squeezed since the walkout began Tuesday.

Early this week, President Yoon Suk Yeol said the government won’t surrender to the doctors’ collective action this time as it did in 2014 and 2020, when it failed to adopt telemedicine services and to increase the medical school enrollment quota, respectively.

A recent Gallop Korea poll shows about 76 percent of respondents were in favor of the government’s plan, regardless of political affiliation. (Yonhap)

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Trainee doctors, which include interns and resident doctors, constitute approximately 30 to 40 percent of the total medical staff at large hospitals. They play a pivotal role in emergency procedures, providing crucial assistance to medical experts.

Bracing for the looming walkout, large hospitals have begun adjusting surgery schedules based on the severity of a patient’s illness. Health authorities are also formulating various contingency plans, including proposals to make emergency rooms at military hospitals accessible to the public. These measures are intended to mitigate potential disruptions in patient care resulting from the impending walkout by trainee doctors.

The imminent collective action by junior doctors is a response to the government’s announcement on Feb. 6 of plans to increase the annual enrollment quota at 40 medical schools nationwide. The proposed increase would raise the quota from the current 3,058 to 5,058 starting next year.

The government has been seeking to raise the medical school enrollment quota to address shortages of doctors and improve public access to medical services.

On the other hand, doctors and medical school students raised concerns that expanding the number of placements could adversely affect the quality of education and training. They said the government should instead explore ways to improve the working environment of physicians and better allocate them.

Trainee doctors at major hospitals nationwide, including ones at the so-called “big five” hospitals in Seoul — Seoul National University Hospital, Seoul Asan Medical Center, Samsung Medical Center, Severance Hospital and Seoul St. Mary’s Hospital — were poised to submit their letters of resignation en masse and stop working on Tuesday.

Among them, some trainee doctors at Severance Hospital already stopped working on Monday, with others continuing to take part in the submission of resignation letters.

“We have reduced our surgery room operations to about 50 to 60 percent of the ordinary rate in preparation for a collective walkout of trainee doctors,” an official at Severance Hospital said.

According to the Ministry of Health and Welfare, there are approximately 13,000 trainee doctors stationed at 221 teaching hospitals nationwide. Among them, around 2,745, constituting about 21 percent of the total, are employed at the five major hospitals in Seoul.

Concerns are rising that actions by trainee doctors could pose a serious threat to hospital operations and patient care across the country.

The health ministry reiterated its firm stance against any collective action, ordering all trainee doctors to keep providing medical services.

“This order is effective immediately,” Second Vice Health Minister Park Min-soo said during a media briefing. “We will carry out on-site inspections to monitor the situation. We will disclose everything transparently and promptly.”

In a bid to mitigate potential medical disruptions stemming from the impending walkout, Prime Minister Han Duck-soo announced that the government will significantly expand telemedicine services.

Telemedicine, or non-face-to-face medical treatments, which is technically illegal under the current Medical Services Act, was temporarily allowed in Korea in February 2020 due to the COVID-19 pandemic, enabling people to use phone consultations and prescriptions for a limited time. After the public health crisis came to an end, telemedicine continued as a pilot project in June last year with available services significantly narrowed.

“The government will also expand the consulting hours of 97 public hospitals and open the emergency rooms of 12 military hospitals to the public,” Han said during an emergency meeting with relevant ministers.

Medical students are also mobilizing to join the protests by collectively taking leaves of absence. Representatives from 35 out of 40 medical schools unanimously agreed to submit applications for leaves of absence on Tuesday.

In response, Education Minister Lee Ju-ho convened a video conference with the presidents of the 40 medical schools on Monday, urging them to closely monitor the situation and manage their students effectively.

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In a similar move, medical students agreed to take a leave of absence en masse.

Intensified protests by young doctors raise concerns that patients may find themselves unable to receive adequate and timely medical services. But the government continued to take an unmovable stance, saying there will be no leniency for those engaging in collective actions.

Tensions between doctors and the government have escalated, with both sides showing no sign of backing down, over the health ministry’s Feb. 6 announcement that the annual enrollment quota at 40 medical schools nationwide will increase next year to 5,058 from the current 3,058.

According to the Korean Intern Resident Association (KIRA), an association of interns and resident doctors, trainee doctors at the so-called “big five” hospitals in Seoul — Seoul National University Hospital, Seoul Asan Medical Center, Samsung Medical Center, Severance Hospital and Seoul St. Mary’s Hospital — decided to submit their letters of resignation en masse on Monday and stop working at 6 a.m. on Tuesday.

The strike threat by interns and resident doctors is considered serious, as they play a key role in emergency rooms and intensive care units at large hospitals.

When the previous Moon Jae-in government was pushing to raise the medical school enrollment quota in 2020, collective action by trainee doctors caused substantial inconveniences for patients, especially at the peak of the COVID-19 pandemic. This eventually led the Moon government to retract its proposal.

The latest decision made by trainee doctors at the big five hospitals raised the possibility of those at other hospitals joining in.

At Wonkwang University Hospital, all 126 of its trainee doctors had already submitted their letters of resignation en masse, expressing their intention to work until March 15 and quit.

According to the Ministry of Health and Welfare, 154 trainee doctors at seven hospitals, including the 126 at Wonkwang University Hospital, have submitted their letters of resignation as of Thursday.

None of these resignation letters have been accepted, the ministry noted.

In response to actions by junior doctors, the health ministry ordered 221 teaching hospitals across the country to put an effective ban on mass leave and ensure they maintain essential medical personnel.

The ministry said leaving hospitals is equivalent to refusing patients, and in this case, the government can issue an order for doctors to return to work, citing the Medical Service Act. Violators of this order face suspension of their licenses for up to one year or imprisonment of up to three years.

The law also stipulates that the government possesses the authority to potentially revoke doctors’ licenses should they be sentenced by a court after failing to adhere to this order.

“The government will mobilize all available legal and administrative measures against any actions that take hostage the lives of patients, to protect the safety of the public,” Second Vice Health Minister Park Min-soo said during a media briefing.

Medical students, for their part, are also moving to join the protests by taking an en masse leave of absence. Representatives from 35 medical schools out of 40 agreed unanimously to apply for leave of absence on Tuesday.

In response, the Ministry of Education urged medical schools to monitor the situation closely.

The government has been seeking to raise the medical school enrollment quota to address shortages of doctors and improve public access to medical services.

On the other hand, doctors and medical students raised concerns that expanding the number of placements could adversely affect the quality of education and training.

In a Gallup Korea survey of 1,002 adults, released also on Friday, 76 percent of participants supported the government’s plan, while 16 percent disagreed with it, and 9 percent reserved judgment.

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