Despite the government's ultimatum for disciplinary actions ending on Thursday, thousands of Korean medical residents have yet to return to work. As of Tuesday, a total of 9,267 residents from 100 training hospitals were ordered to return, with 5,976 confirmed to have not complied with the order.

Vice Minister of Health and Welfare Park Min-soo warned on Thursday that if a medical error occurs during the absence of junior doctors, the government may attribute blame to the absent junior doctors, not those remaining at the hospital treating patients.

"An investigation into the cause of the accident will be conducted, and we will determine who is responsible based on the outcome of the investigation," he said. "This means that the fault won't necessarily be transferred to the medical staff on-site."

Park further elaborated, "If an accident occurred because an absent resident doctor, who was supposed to be present at that time, was not there, then the absent resident doctor could also be held responsible."

The government will begin administrative punishments for medical residents who fail to return to work by Thursday starting from March 4.

Most junior doctors have no interest in returning

Despite the impending deadline and legal threats, the return of medical residents to hospitals remains uncertain, with major hospitals in Seoul reporting no significant movement. Reports from Seoul's Big Five hospitals - Seoul National University Hospital, Severance Hospital, Samsung Medical Center, Asan Medical Center, and the Catholic University of Korea Seoul St. Mary's Hospital - indicate no noticeable return of residents.

A professor from one of the Big Five hospitals mentioned that while there are rumors of some residents returning to the field, actual instances of residents coming back are hard to find.

"Even among our department's residents, there seems to be no interest in returning," the professor said.

According to the Korean Medical Association's informal survey, the association estimates the return rate of residents at about 15 percent.

This figure is higher than perceived, but a Professor at a tertiary hospital in Seoul stressed that the figure is influenced by residents who submitted their resignations but continued to care for patients.

"These residents, despite resigning, have chosen to remain at their posts to take care of patients quietly," he said.

Vice Minister Park suggests meeting with resident doctors

Meanwhile, in a pivotal move ahead of the government's set deadline for the return of medical residents, Vice Minister Park reached out for dialogue with the resigned resident doctors.

According to the medical community, Park sent a text message on Wednesday proposing a meeting at 4:00 pm Thursday at the office located in Yeouido, Seoul. The meeting is to be held in private.

"Despite multiple official announcements calling for dialogue and attempts to contact representatives, the government has been unable to reach resident doctors," Park. "Hence, we have decided on a time and place."

Park emphasized that the dialogue is open to any resident doctor who wishes to participate.

However, the response from the medical residents has not been favorable.

"The government's vacillating stance makes it impossible to trust them," a resident doctor told Korea Biomedical Review. "They talk about dialogue, then insist there will be no compromise, and then threaten severe punishment."

If the government truly wants to resolve the issue, they should hire more full-time specialists, and that's also a demand from residents, he added.

The resident stressed that ultimately if the government does not provide a clear answer to the demand for increasing the hiring of specialists and only threatens medical residents to return, he has no plans to return to his hospital.

Another resident echoed this sentiment, criticizing the government's approach as manipulative, "It feels like the government is treating us like criminals, offering leniency as if they're doing us a favor."

The government is not addressing the root causes of the crisis, just threatening us to return under conditions that haven't improved, he added.

The fear of retaliation for engaging in dialogue with the government was also palpable among the residents.

A resident from a training hospital in the South Jeolla Province shared his apprehensions,

"Going to the proposed talk with the government feels like walking into a trap," she said. "Even the President has created a climate of fear, threatening to round us all up, and now they suddenly want to have an open and honest conversation? It's insulting."

Patients exhausted by ongoing healthcare gaps

Amidst the ongoing feud between the government and the medical community, patient advocacy groups have stepped forward, urging the resigned medical residents to return to the hospitals.

On Thursday, the Korea Alliance of Patient Organizations and its nine affiliated groups held a press conference in front of the National Human Rights Commission.

They acknowledged the constitutional right of medical students and residents to express opposition to medical school expansion and other policies in various ways.

However, they highlighted the grave potential for emergency and severe patients to suffer critical harm if the collective action by residents becomes prolonged.

"The current psychological distress of patients and their families is severe," they stated, noting that the government's emergency medical measures have not alleviated the psychological distress and frustration experienced by patients with postponed surgeries and outpatient appointments and their families.

The patient groups criticized the medical residents' collective action, questioning the ethics of causing significant harm to life through opposition to government policies, stating that exploiting their exclusive right to perform medical acts to the detriment of severe and emergency patients cannot be justified under any pretext.

The organization argued for the establishment of a healthcare service system centered around specialists to create an environment where residents can focus on their training.

"Residents hold a dual status as licensed physicians capable of performing medical acts and as students undergoing training to become specialists," the organization said. "The two instances of collective action by residents in 2020 and this year, which led to gaps in healthcare, teach us that we must swiftly reform to a system where specialists, not residents, are at the core of patient treatment."

Furthermore, they suggested the institutionalization of physician assistants (PAs) to play a complementary role in the event of future collective actions.

"The actual number of PAs actively working in the medical field is estimated to be between 10,000 and 20,000," the organization said. "Like some countries abroad, our country should actively consider creating a legal basis for establishing a separate medical profession for these individuals."

If these individuals can play a complementary role during collective actions by residents, it would minimize the harm to the lives and health of severe and emergency patients, they added.