Small cities bear brunt of South Korea doctor strike

Hospitals outside Seoul struggle with lack of physicians in a trend that is set to worsen

Hospitals in South Korea’s smaller cities are struggling with a lack of physicians, as a nationwide strike of trainee doctors enters its third month in protest against plans to tackle the shortage by boosting medical school admissions.

Seoul, the capital, boasts toplevel hospitals, but smaller cities are starved of doctors in a trend experts say will only get worse as the population ages at one of the world’s fastest rates, while birth rates are the lowest in the world.

“Our artificial kidney room was closed for almost two years because we didn’t have a doctor and we couldn’t find one … but this is a national phenomenon,” said Cho Seung-yeon, director of the Incheon Medical Centre in the port city.

The shortage is at the heart of government plans to add thousands of medical school students from 2025 that face opposition from trainee doctors and some groups who doubt it will improve poor working conditions.

South Korea has 2.6 doctors for every 1,000 people, one of the lowest rates among developed countries, according to the Organisation of Economic Cooperation and Development. In contrast, top-ranked Austria has 5.5 for every 1,000 people.

“I hope the number of doctors will increase in the future, due to our rapidly ageing society which means more and more people will visit hospitals,” said Yoo Byungseon, 66, one of those being treated in the Incheon hospital.

Because it could not find staff, the hospital’s cardiology department had resorted to using roving doctors from a nearby university hospital, Cho added.

In a complaint last week the Korea Medical Association, a leading critic of the government’s reforms, accused Cho and another employee of breaking the law by using unlicensed personnel for some medical procedures.

Cho denied those claims, a hospital spokesperson said.

Medical interns and resident doctors who began their strike late in February say they are underpaid and overworked, conditions the government must tackle before adding more physicians.

Cho acknowledged policies must also change to ensure the new doctors work in underserved areas and do not just gravitate back to Seoul, but adding practitioners was a necessary first step.

The prolonged strike would only hurt physician assistants who often performed some of a doctor’s duties though without the same protection, said Choi Heesun, president of the Korean Health and Medical Workers’ Union. “It’s only doctors who say there is no shortage of doctors,” she said, faulting both the government and striking doctors for early failures to strike up dialogue.

Medical outcomes can vary widely outside the capital, where government figures show there were 4.82 active doctors for every 1,000 people in 2022, compared to Incheon’s equivalent of 2.65.

The city racked up South Korea’s highest rate of avoidable deaths, an indicator of healthcare quality, at 51.49 per 100,000 people in 2021, while the corresponding rate for Seoul was 38.56, health ministry figures show.