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J Korean Matern Child Health > Volume 29(1); 2025 > Article
Lee: The State of Obstetrics and Gynecology During the 2024 Healthcare Crisis in Korea

Introduction

The healthcare crisis of 2024 in the Republic of Korea arose from a pronounced conflict between governmental authorities and the medical profession regarding the expansion of medical school enrollment. The mass resignation of resident physicians, coupled with the collective withdrawal of medical students from their studies, caused significant disruptions in the healthcare delivery system. These disruptions severely affected essential medical specialties, most notably obstetrics and gynecology.

Core Issues of the 2024 Healthcare Crisis in South Korea

The government introduced an Essential Healthcare Policy Package comprising four main pillars: expanding the healthcare workforce, strengthening regional healthcare services, establishing a safety net for medical accidents, and promoting greater fairness in the compensation structure for healthcare professionals. As part of the plan to expand the healthcare workforce, the government pursued the expansion of medical school admission quotas. In February 2024, the South Korean government announced a substantial increase in its medical workforce, aiming to add 2,000 medical graduates annually starting in 2025. This marks a significant 67% increase from the current 3,058 graduates (Yoon et al., 2024).
The policy announcement triggered immediate backlash, with resident doctors submitting mass resignations and medical students collective taking leave. This was followed by a large-scale rally organized by the Korean Medical Association, during which physicians strongly criticized the government's actions. Data from the Ministry of Health and Welfare high-lighted the severity of the situation: as of January 8th, only 1,173 out of 13,531 eligible resident doctors (just 8.7%) were reporting for duty (Ahn, 2025; Park, 2024).
While public perception of the government's healthcare reform agenda may appear positive, the policy proposals lack sufficient empirical evidence and instead rely on broad gener-alizations. The government's policy package identified pro-longed working hours and widespread burnout as key factors driving reduced interest in essential medical specialties, attri-buting this trend to the 19-year stagnation in medical school enrollment. However, this explanation does not sufficiently address the complex factors contributing to workforce shortages in critical disciplines.
Medical graduates typically choose their specialization after completing internships. Therefore, merely increasing the number of graduates without implementing complementary measures to incentivize specialization in essential fields may aggravate systemic dysfunction. The government's reliance on a ‘trickle-down’ model—assuming that an oversupply of physicians will eventually populate essential service areas— overlooks the dedication and contributions of current practitioners in these demanding specialties. This approach effectively reduces their efforts to a simple ‘trickle-down’ effect.
The ongoing conflict between the medical profession and the government produced unintended consequences, accelera-ting the erosion of essential and regional healthcare services.

The Reality and Challenges of Obstetrics and Gynecology

Even prior to the current healthcare crisis, the field of obstetrics and gynecology faced significant challenges, including insufficient reimbursement for obstetric procedures, substantial legal liabilities from medical malpractice, a declining number of incoming resident physicians, and the progressive aging of the physician workforce. The present crisis has exacerbated these longstanding vulnerabilities within this specialty.
According to a survey conducted by the Korean Society of Ob stetrics and Gynecology, a significant proportion of the 123 incoming first-year resident physicians in obstetrics and gynecology, originally scheduled to begin their training in March 2024, are unlikely to return to their training institutions following the crisis (Lim, 2024). The resident physicians have explicitly stated they will remain absent from clinical duties unless comprehensive measures are implemented to address the systemic challenges impacting essential medical care delivery.
The absence of resident physicians has significantly increased the clinical and administrative burdens on the remaining fa-culty and specialist physicians. This escalation in workload has raised concerns about occupational burnout among healthcare personnel, potentially leading to a decline in the quality of medical care and an acceleration of professional attrition. The resulting service disruptions have generated widespread public concern about access to timely medical interventions in emergency situations, causing considerable hardships on preg-nant patients and other requiring urgent medical attention.
Prolonged workforce shortages within the resident physician cohort, driven by the ongoing medical crisis, pose a serious threat to the training pipeline for future specialists in obstetrics and gynecology, potentially resulting in systemic failures within the healthcare infrastructure. A survey of 111 obstetrics and gynecology specialists at university hospitals nationwide, conducted by the Korean Society of Obstetrics and Gynecology, found that 76% considered resigning following a medical dispute in February. Seventeen percent had already submitted resignation letters or looked for new positions. Many expressed reluctance to quit due to concerns for their patients (Oh, 2024). This precarious situation is further aggravated by the potential for accelerated retirements among the aging cohort of established practitioners. A 2021 research study found that the average age of obstetricians in South Korea was 51.8 years (Lee et al., 2021). The increasing age of obstetricians and gyn ecologists suggests a concerning trend of fewer active phy sicians in this field, potentially leading to a shortage of healthcare providers in obstetrics and gynecology.
This crisis has had a detrimental effect on medical education, research, and journal submissions. Data from 2024 sub missions to leading Korean medical journals, including the Journal of Korean Medical Science and Yonsei Medical Journal, revealed a 30% decline compared to the previous year (Jung et al., 2025). The number of submissions to the Korean Journal of Obstetrics and Gynecology experienced a significant increase of 17%, from 296 papers in 2023 to 347 in the following year, primarily attributed to the active parti-cipation of international researchers. In contrast, the number of submissions from domestic authors decreased by 4.1%, from 13.9% (41 papers) to 9.8% (34 papers) during the same period (Jung, 2024). The excessive workload placed on medical professionals has significantly constrained their research ca-pa bilities, potentially jeopardizing the nation's competitive edge in this field on the global stage (Jung et al., 2025).

Conclusion

The 2024 healthcare crisis clearly revealed systemic vulnerabilities within essential medical disciplines, particularly obstetrics and gynecology. A quantitative increase in the physician workforce is insufficient to redress these multifaceted challenges. Instead, fundamental structural reforms are urgently required, including the establishment of equitable reimbursement mechanisms, improvements in professional working conditions, and the mitigation of medico-legal liabilities.
Despite the ongoing demographic trend of declining birth rates, obstetrics and gynecology remain essential for safeguar-ding women's reproductive health and ensuring safe childbirth. This underscores the need for sustained government and so-cietal attention, as well as continued investment in this critical specialty. Expert consultation, and rigorous scientific analysis, and systematic strategic planning are crucial for developing and implementing effective policies to prevent systemic collapse and maintain optimal public health outcomes.

이해관계(CONFLICT OF INTEREST)

The author has nothing to disclose.

REFERENCES

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Jung HM. “I don't even have time to fix the paper I wrote” One year of medical conflict, medical research stopped. Chosun Ilbo [Internet] 2024 Oct 20;[cited 2025 Jan 20]. Available from: https://www.chosun.com/national/welfare-medical/2025/01/20/HTC6ZWKS2BFNROGW6A2AFRD6OY/

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Oh KM. [Exclusive] 3 out of 4 obstetricians at university hospitals nationwide consider resignation after protocol conflict. Chosun Ilbo [Internet] 2024 Oct 3;[cited 2025 Jan 14]. Available from: https://www.chosun.com/national/welfare-medical/2024/10/03/MCKKLN5JVNA3RISWDPJWOUYBQQ/

Park HW. Encouraging message from the Korean Academy of Medical Sciences to junior doctors in struggle. J Korean Med Sci 2024;39:e108.
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