A 16-month-long government-doctor conflict is unable to find a way out. The hope that a change in political power will soon lead to a turnaround is fading.

Tripling – in which 2024, 25, and 26 classes must take classes at once- has become a reality, but there is no clear alternative. The voices of the medical community, divided between those who say “it's time to go back” and those who say “not yet,” are not getting any traction.

This explains why people ask, "What is the Korean Medical Association (KMA) doing now?" inside and outside the medical community.

Hwang Kyu-seok, president of the Seoul Medical Association (SMA), recently met with journalists and said that the KMA’s "consistency of no-response" has led to this situation. The KMA leadership, led by President Kim Taek-woo, who took office in January, "let major inflection points pass by," Hwang said.

Internal discussions were postponed while waiting for the government to act, and in the end, time was lost without action. As an "insider" who is also a KMA vice president, Hwang said it is "painful" that an executive created with young doctors' support has not met their expectations.

However, the SMA head said there are still “opportunities.” He emphasized that the inauguration of the Lee Myung administration was a turning point and that the KMA must "proactively propose solutions." As healthcare policy actors, the KMA must restore trust among patients, the public, and the medical community. He called for improving the structure for collecting opinions and strategically persuading the public to "lay the groundwork for return by trainee doctors and medical students."

The SMA is already moving. It plans to establish a council of junior doctors and medical students to open a dialogue between the medical community and the government.

"We want to go beyond the stage of transmitting the voices of young people," to a structure where they participate directly,” he said. Hwang also wants to provide clinical training opportunities and better organize legal and financial support. He believes that measures and systems can only work if the wounded identity of medical professionals is healed.

"The medical community was originally one," Hwang said. He stressed that the medical community must speak with one voice again, breaking the frame that separates professors and trainee doctors, general practitioners and medical students and that the SMA will "stand at the forefront of that journey."

The following are questions and answers from the news conference.

Question: You are the SMA president and a KMA vice president. The KMA leadership, led by President Kim Taek-woo, has been criticized for falling short of expectations despite the support of young doctors. How do you see it as an outsider and an insider?

Answer: It's a painful point. The internal opinion-gathering structure was rigid, and there was a lack of communication with the younger generation. The policy response messages were inconsistent, and the timing of decisions was often late. While the government pushed through policies, the KMA remained in internal consensus. Last December, this February, and May, when “tripling” became visible, were all critical junctures. At each point, the outcome could have been different if there had been responsible decisions or direction. Now is the time to reform the organizational culture and strengthen the media strategy. We need a strategy and execution to convince the medical community and the public.

Q: The KMA demands an apology and a solution from the Lee Jae-myung administration, saying that the government should be held accountable.

A: It is necessary for the incumbent government to acknowledge the mistakes of the previous government. However, it is also true that the current conflict or “healthcare reform” originated from the previous government, and the current government is not responsible for the process. The government has changed, and the current government has not yet appointed anyone in charge. The KMA demands policy alternatives without a new health and welfare minister and vice minister, saying they will only talk after they are appointed. It is doubtful that this attitude will help prepare practical alternatives and resolve the situation.

The KMA should organize its policy direction and refine the needs of the younger generation before starting a dialogue with the government. It is more realistic to take the initiative by reviewing the seven proposals for trainee doctors and eight for medical students to propose alternatives for the medical community.

Q: What direction change in medical policy would you like to see from the Lee Jae-myung administration?

A: The government-doctor conflict will not end when medical students and doctors "return to their positions.” It's time to design a new healthcare system that is different from the existing one, so approach the conflict from the perspective of history, not politics. The government must design an ecosystem where healthcare can work effectively with the medical community.

The government has unilaterally pursued significant policies, such as expanding the number of medical students and establishing public medical schools. Healthcare policies should be based on rational, scientific evidence and social consensus. The medical community is not against change, but a piecemeal approach to solving the medical workforce shortage, including the medical school enrollment quota increase, is not beneficial to anyone.

Q: How should our society solve the problem of trainee doctors’ resignations and medical students taking leave of absence?

A: The key is to restore trust. The government needs to start a genuine dialog with young doctors now. More executive orders or pressure to flunk them will only prolong the conflict. It can't convince them to return if it doesn’t rebuild trust in its policies. It must hold officials accountable for policy failures and demonstrate “policy predictability” through consistent standards and fulfillment of promises.

Since the beginning of the crisis, the SMA has met with representatives of junior doctors and medical students. They have demanded realistic adjustments, including a moratorium on flunking, and urged the government to keep the possibility of revising the policy open.

The SMA is organizing a council with direct participation from trainee doctors and medical students. We want to formalize it as a communication channel with the government. The goal is to move beyond the stage of simply relaying the opinions of young people to a structure where they participate in policy discussions themselves.

Q: Are there other support programs organized by the SMA?

A: In addition to short-term incentives to return to work, long-term support programs are in place to help young doctors return to the medical field. One example is training courses to maintain clinical skills. We provide opportunities for them to gain experience and maintain their clinical sensitivity by connecting them with secondary hospitals, small—and medium-sized hospitals, and regional network hospitals and clinics in Seoul.

It also plans to operate an expert advisory group to respond to administrative issues, such as flunking and expulsion. It is considered an academic incentive program for medical students. The SMA also considers organizing a back-to-school program to reflect on the situation through the eyes of young people. The SMA wants to not only lay the groundwork for a comeback but also restore the sustainability of the medical profession.

Q: Any additional messages?

A: The people most hurt right now are trainee doctors and medical students. They have not just given up on their careers, but their identity as medical professionals has been deeply wounded. The SMA will never ignore their frustration, anger, loneliness, and anxiety.

The medical community has been too divided. Professors, doctors, medical residents, and students have spoken differently, but we were once one. The framing of the middleman exploiter, the selfish professor, and the isolated student must end. We must return to a senior-junior relationship of respect, trust, and affection.

The SMA will be the starting point for that restoration. To be at the forefront of the medical community's recovery journey, we will dialogue with the Lee Myung-bak government, cooperate with the National Assembly, and stand in solidarity with local communities. We will pave the way for young doctors to return to the medical field, not just to return but to prepare for the next 100 years of medicine. Together, we can overcome this challenge.