In response to a mass resignation of trainee physicians that has led to significant medical disruptions, the Korean government said it would spend 200 billion won ($150.1 million) per month into the healthcare system to maintain emergency and patient care.

The Ministry of Health and Welfare on Thursday announced plans to allocate monthly health insurance funds of approximately 188.2 billion won, on top of a previously decided emergency reserve of 128.5 billion won.

These include additional compensation for hospitals actively treating severe cases and redirecting patients with mild symptoms to lower-tier hospitals.

Also, to respond to emergency situations, new policy support funds will be established for specialists, including professors, when they treat critically ill patients. Compensation for the rapid response teams in general wards responding to emergencies, such as cardiac arrest, will also be enhanced.

Furthermore, compensation for the rapid transfer of emergency patients and the maintenance of a 24-hour emergency medical system will be strengthened.

The move comes as a direct countermeasure to the ongoing crisis, sparked by collective action from resident doctors across the nation in protest against government policies, including plans to increase the number of medical students. As of Wednesday morning, a staggering 91.8 percent of surveyed resident doctors in 100 training hospitals (11,219 out of 12,225) had abandoned their positions, according to the health ministry. 

The government has begun sending pre-notification letters of administrative orders to those who have not returned to work, violating orders to resume duties, as it seeks to maintain control over the escalating situation.

The government stressed that the emergency medical system has been maintained without significant confusion in the medical field so far.

As of Wednesday at noon, the operation rate of general hospital beds in emergency rooms was 29 percent, and the operation rate of intensive care unit beds was 71 percent, which is said to be similar to the level before the collective action, according to the Ministry of Health and Welfare.

The ministry also said the intensive care units of the Big 5 hospitals -- Samsung Medical Center, Asan Medical Center, Seoul National University Hospital, Severance Hospital, and Seoul St. Mary's Hospital -- are being operated without reduction, and emergency rooms are maintaining their function focusing on critically ill patients. However, the atmosphere reported from the medical field is significantly more serious than what the government said.

Despite the government's efforts to bridge the gap with emergency funds and policy adjustments, medical faculty from leading universities, who have been filling in to treat patients after resident doctors started their collective action, have escalated their protest actions.

Professors and medical professionals are issuing joint statements and, in some instances, resigning en masse to protest the planned increase in the number of medical students.

For instance, a crisis committee comprising professors from Chungbuk National University Hospital held a press conference condemning the government's policy on increasing medical school admissions on Wednesday. Similarly, the faculty association of Ulsan College of Medicine scheduled a general meeting to decide on the specifics of collective action in light of the crisis's severity on Thursday.

Also, the dean's office at the Catholic University of Korea School of Medicine submitted resignation letters in a gesture of accountability for not preventing the government's application for increasing medical student admissions.

This level of dissent underscores the depth of disagreement within the medical community regarding the path forward.

Hospitals have been forced to take drastic measures in response to the dwindling number of inpatients and surgeries due to the collective departure of resident doctors.

These include reducing the number of beds, accepting staff unpaid leave requests, and directly confronting revenue declines.

Hospitals have been adapting to the acute staff shortage by restructuring their operations. Chonnam National University Hospital has closed two wards due to a rapid decrease in inpatient numbers, reallocating medical personnel to emergency and intensive care units and essential medical departments.

Pusan National University Hospital has begun integrating wards with similar medical services, while Dong-A University Hospital has halved its emergency room beds from 40 to 20 to manage the crisis more effectively.

Government expands nurses' roles

Amid a deepening healthcare crisis due to a nationwide doctor strike, the Korean government has taken a significant step by expanding the scope of tasks that nurses can legally perform. This expansion includes emergency procedures such as cardiopulmonary resuscitation (CPR) and the administration of emergency medications, tasks previously considered the sole domain of doctors.

They are also allowed to collect various specimens and conduct tests such as electrocardiograms (EKGs), ultrasounds, and Covid-19 screenings.

Under these revised guidelines, nurses are now authorized to perform a variety of medical tasks, excluding five specific prohibitions defined by the Supreme Court and other restricted activities such as X-ray imaging, acting as surgery proxies, administering general anesthesia, and prescribing specialized medications.

However, physician assistant (PA) nurses are empowered to carry out delegated testing and drug prescriptions, and can draft preliminary documents for medical records, test requests, diagnoses, patient transfers, and surgical consent forms.

Furthermore, these nurses can participate in surgical procedures, such as suturing, apply casts or splints, perform extracorporeal shock wave lithotripsy, and insert foley catheters.

Notably, PA nurses are also capable of performing more complex procedures, including intubation and extubation of critically ill patients, central venous catheter insertion and management, and cerebrospinal fluid collection.