Fears of a health care crisis were brewing in South Korea on Monday, as doctors and medical residents discussed taking collective action in protest of the government's planned hike in the medical school student quota.

The Korean Medical Association, the country's largest coalition of doctors groups with 130,000 members, threatened to go on strike on Thursday and hold a national meeting of doctors in Seoul on Saturday. Another group of interns, residents and trainee doctors, the Korean Intern Resident Association, was set to hold an online meeting Monday evening on whether to take collective action against the government's plan to expand student quota by 2,000.

Earlier, the KIRA said that its poll of around 10,000 doctors showed 88.2 percent of respondents would take collective action, including strikes, should the government proceed with raising the medical school quota.

If doctors were to go on strike nationwide, it would mark their fifth strike, following sit-in protests in 2000, 2012, 2014 and 2020. During the previous strike four years ago, doctors protested against the same issue of medical school expansion. The strike ended with the government withdrawing the plan due to public concern over medical shortages during the COVID-19 pandemic.

President Yoon Suk Yeol's office said later in the afternoon that the plan to expand the medical student quota was "irreversible" and that the planned strike by doctors lacks sufficient rationale.

A senior official, speaking on condition of anonymity, informed reporters that the plan has faced obstacles in the past for various reasons and that the country has now reached a juncture where retracting the plan is not advisable. The government referred to the 2021 Organization for Economic Cooperation Health Statistics report, in which Korea recorded 2.6 active clinicians per 1,000 people, far lower than Austria, Norway, and Germany with respective counts of 5.4, 5.2 and 4.5 clinicians per 1,000 individuals.

Stressing that the government's plan to expand the medical school student quota is legitimate, Health Minister Cho Kyoo-hong also wrote a letter on Facebook on Monday in which he said residents and other trainees should not "doubt" the government's efforts in improving sustainability at hospitals.

The Health Ministry last week announced a decision to raise the number of medical students to 5,058 starting next year to address the chronic shortage of doctors in rural areas and in essential health care fields.

“The goal of this policy is to improve the system where residents are unable to focus on training due to excessive workloads so that they can better hone their capabilities and qualifications during training,” Cho said.

“Saving lives is always going to be difficult, but we want to have at least more people join in the effort to reduce the burden,” Cho added.

According to the Health Ministry, doctors' taking collective actions is illegal because they are not “workers” but specialists who don't have the right to strike guaranteed by the constitution. The KMA, the largest group of doctors here, don't have the legal right to go on strike also because they are self-employed, the ministry said. Some argue that residents hired by large teaching hospitals can be seen as "workers" and therefore, have the right to take collective action. But local reports, quoting legal experts and insiders, say their legal status is also ambiguous because they sign a "training contract" with the hospitals to become a specialist, not a labor contract.

The ministry said it would issue a back-to-work order in response to doctors' taking collective action. By law, the government can strip medical licenses if the administrative order of returning to work is not followed, it added.

Doctors may have their medical licenses revoked and receive prison terms of up to three years or be fined up to 30 million won ($22,600) if they do not comply. Doctors can also be punished for breaching the Medical Service Act and fair trade laws, as well as for the obstruction of business operations if they refuse to provide medical treatment en masse.

Meanwhile, the Health Ministry established a dedicated headquarters for collective action by physicians and raised the national health crisis level to alert -- the third highest in the four-tier warning system -- in connection with the potential strike. It has set up a central accident management headquarters within the ministry to deal with doctors’ collective action. The ministry has also established emergency medical response situation rooms in central and local governments to prevent disruption at medical centers.