[The Era of Medical Student Cartels]⑥ Professor Kwon Yongjin "Professional Ethics Must Be Correctly Established"

"Taking a Leave Due to Uncertainty About the Future?... Medical Students Have the Most Stability"
"For Doctors to Gain Recognition, They Must Manage Their Own Quality"

Editor's NoteSince last February, residents who left hospitals in protest against the government's policy to increase the number of medical school students have not returned for two years. Medical students who followed their seniors in boycotting classes and collectively taking leaves of absence have largely accepted the government's and universities' warnings to either repeat a year or face expulsion by returning to school for now, but the possibility remains that they will continue their struggle through re-leaves and class boycotts. Even if the medical school environment appears to be barely normalizing, the collective nature of the medical students and the impact of their power are unlikely to fade easily. Asia Economy analyzes over six installments how and why they can unite so tightly like a 'cartel.'

On the 18th of last month, Professor Kwon Yong-jin of Seoul National University Hospital's Public Medical Center proposed, "Let's improve Korea's Japanese-style apprenticeship training system in medical schools and switch to the German-style 'annual training system'." This came at a time when four professors from Seoul National University College of Medicine strongly criticized some residents and medical students who were urging their peers not to register ahead of the government and universities' deadline for medical students to return to classes, and resigned residents rebutted this, heightening tensions within the medical community.

Professor Kwon Yong-jin of the Public Medical Center at Seoul National University Hospital is being interviewed by Asia Economy on the 27th of last month in his office in Jongno-gu, Seoul. Photo by Kang Jin-hyung

In an interview with Asia Economy on the 26th of last month, Professor Kwon said, "It is undesirable that conflicts between professors and residents are escalating due to a small number of residents who speak recklessly and a small number of professors who are uninterested in teaching," adding, "In reality, the relationship between professors and residents is no longer the Confucian master-disciple relationship, so changes are needed in Korea's apprenticeship training system."

Professor Kwon is a medical doctor and holds a Ph.D. in law, specializing in healthcare policy and administration. During the 2000 pharmaceutical separation crisis, he served as the general secretary of the Korean Medical Association's Committee for the Defense of Medical Rights, leading the fight against the government. However, since last year, he has been offering critical suggestions regarding the collective resignation of residents and medical students' leaves of absence.

Below is a Q&A with Professor Kwon.

- Medical students are registering to avoid expulsion.

▲ It seems they are registering but not attending classes. They reportedly decided this through a vote among themselves beforehand, but if a debate arises later about whether this constitutes collective action, it could become problematic. It would have been better if everyone acted according to their own opinions... If they return to school but collectively refuse to attend classes, that would be collective action.

- Public opinion has worsened due to fairness issues with students from other departments.

▲ Society can no longer give special treatment only to medical students. They are still students who have not yet obtained medical licenses, but acting as if they are already doctors is inappropriate. If they take leaves of absence because their future careers are uncertain, are medical students the only unstable university students? Medical students have the most stable futures, so it is difficult to persuade society through collective action. They are mistaken.

- What should medical students have done?

▲ The reason students are respected by society is because it is objective. Medical students should be at least objective and critical regarding government and medical community issues, but now they have become stakeholders. They can oppose policies through collective action, but the responsibility and damage fall on themselves.

- It is said that individual action is difficult due to the nature of the medical education curriculum.

▲ That is nonsense. Such solidarity is weak solidarity. As intellectuals, they should respect diversity the most, so why do high-achieving students watch each other and do nothing? I don't think it's the students' fault.

Currently, intellectuals in Korean society are all similar. They should be able to say politics shouldn't be like this, society shouldn't be like this. There are no intellectuals discussing social integration or Korean society's problems, and the professor group is the same. It is a pathological phenomenon of Korean society as a whole.

- What is the current state of medical students?

▲ They seem to sense that both the government's medical reform and their own methods of struggle have problems, but they don't fully understand. They feel this kind of reform may not be for the people, but they are unclear about the essence of the problem and what to do. The stories from seniors are not entirely correct either, but the students themselves seem uncertain.

On the other hand, there are hardline students saying, "We don't want to mortgage our future," and "We cannot accept that doctors' earnings are no longer guaranteed as before." However, not all students came to medical school just for money. About half probably want to become good doctors.

Professor Kwon Yong-jin of the Public Medical Center at Seoul National University Hospital is being interviewed by Asia Economy on the 27th of last month at his office in Jongno-gu, Seoul. Photo by Kang Jin-hyung

- Some say they cannot return to school because they gained nothing from the struggle.

▲ That is also true. They have been on leave for over a year fighting, but having gained nothing, they might think stopping here is right. I do not think the collective action of medical students is over. It is only just past the midpoint.

- If medical classes do not normalize this time, the classes of 2024, 2025, and 2026 could be 'tripled.'

▲ That is the students' choice. The school is not responsible for problems caused by students being held back. The deterioration of educational conditions is also their choice, and no medical school has an environment to teach students who have been collectively held back.

- Parents are also very worried.

▲ I was surprised to see a statement from a group of medical students' parents amid the medical-government conflict. From the parents' perspective, who want their children to live more comfortably and have succeeded in sending them to medical school through private tutoring since elementary school, it seems they think someone (the government) is trying to undermine and destroy their trophy.

This is a phenomenon unprecedented globally and unique to South Korea. If we talk about medical students' vested interests, in reality, it is the vested interests their parents want to protect. To overcome this phenomenon, changing the system alone will not solve it. It is time to fundamentally review medical education and the entire process of training doctors, so I do not think this issue will end simply.

- What should be done?

▲ All expert groups in Korea?lawyers, professors, religious figures, journalists?are not trusted by the public. The only reason doctors remained trusted until the end was because they continued to treat sick patients. But now residents are starting to claim, "Patients are important, but so are my rights." At first, the public somewhat understood, but as the situation has extended beyond one year into the second year, trust is being lost.

The government should regulate expert groups more rationally, and expert groups should raise their own discipline to avoid infringement on their autonomy, maintaining a tense relationship. However, Korea failed to do this during its rapid growth. Because there is no history of managing professional ethics, this trust has easily collapsed and is difficult to rebuild.

The medical community also failed internally in quality control, and as income disparities between specialties and professions worsened, professional ethics collapsed. To be recognized by society, expert groups must continuously reflect and manage quality themselves.