Surgeries have been delayed and hospitals have turned away patients after more than 1,600 doctors in South Korea went on strike on Tuesday.
The junior doctors are protesting the government’s plans to introduce more trained physicians into the system.
South Korea has one of the lowest doctor-to-patient ratios among major economies, so the government wants to add more medical school placements.
But doctors oppose the prospect of greater competition, observers say.
South Korea has a highly privatised healthcare system where most procedures are tied to insurance payments, and more than 90% of hospitals are private.
Its doctors are among the best-paid in the world, with 2022 data from the Organisation for Economic Co-operation and Development (OECD) showing the average specialist at a public hospital receives nearly $200,000 (£159,000) a year; a salary far exceeding the national average pay.
But there are currently only 2.5 doctors per 1,000 people – the second lowest rate in the OECD group of nations after Mexico.
“More doctors mean more competition and reduced income for them… that is why they are against the proposal to increase physician supply,” said Prof Kwon Soon-man, a public health expert at Seoul National University.
The country has critical physician shortages in remote areas, and in specialities such as paediatrics and obstetrics – which are seen as less lucrative fields compared to practices such as dermatology and plastic surgery.
Nearly 6,500 interns and residents – about half of the junior doctor workforce – tendered resignation letters on Monday, the country’s health ministry said.
Of that group, about 1,600 doctors failed to turn up to work. Protest organisers – the Korean Medical Association and Korea Interns and Residents Association – had urged members to stop work entirely on Tuesday.
The government has ordered doctors to go back to work with President Yoon Suk-yeol condemning a campaign he said was “taking people’s lives and health hostage”.
He said he was aware of cases where cancer surgeries had already been postponed due to the walk-outs. South Korean media have also reported cases of patients having to be discharged or transferred to other hospitals.
Junior doctors form a core contingent of staff in emergency wards, and Yonhap reported that up to 37% of doctors could be affected at the biggest hospitals in Seoul.
“We are deeply disappointed in the situation where trainee doctors are refusing to work,” Second Vice Health Minister Park Min-soo had told reporters earlier this week.
On Tuesday he said the government would resort to legal means to break the strike- authorities have statutory power to revoke a doctor’s practicing licence if their actions threaten national healthcare.
The country has previously brought prosecutions against doctors who were striking. The government said it was taking steps on Tuesday against two officials of the Korean Medical Association.