Photo is unrelated to the article. [Getty Images Bank]
Photo is unrelated to the article. [Getty Images Bank]

The mandatory 780-hour hospital clinical training that aspiring nursing aides must complete to obtain their license is in effect being used to fill staffing gaps at medical facilities, experts say. Labor law specialists argue that trainees who provide substantive work under a hospital's direction and supervision should be recognized as workers under the Labor Standards Act and afforded corresponding protections.

According to the Korea Labor Institute, Park Hyeon-seo, a professor at Pusan National University School of Law, and Choe Jeong-eun, an associate professor at Chung-Ang University School of Law, recently analyzed a nursing aide trainee case decided by the Seoul Northern District Court's appellate division last year. They identified limits of the current system in a newly published labor case review.

The case centers on trainee A, who completed 780 hours of clinical training at a hospital over roughly four and a half months in 2022 and then sued, claiming she had provided actual labor rather than training and seeking wages equivalent to the minimum wage. To sit for the nursing aide licensing exam, candidates must complete at least 740 hours of theoretical instruction and at least 780 hours of clinical training.

The trial court declined to recognize A as a worker, finding no agreement between her and the hospital to pay wages. It did, however, acknowledge that she had provided substantive labor beyond the scope of training for a portion of her placement, ordering the hospital to return an amount equivalent to the minimum wage for 390 hours — half the total training period.

The appellate court reversed that finding, ruling that the training's purpose was education and that no employment contract had been signed, and declining to hold the hospital liable for unjust enrichment. It also found that because A's skills were undeveloped and required continuous supervision by nurses or nursing aides, it was difficult to conclude that the hospital had derived economic benefit from her labor.

The two professors criticized the appellate court for placing excessive weight on the form of the contract rather than the substance — the core of any worker-status determination.

The Supreme Court has consistently held that whether a person qualifies as a worker must be assessed comprehensively by examining whether they provided labor in a subordinate relationship under an employer's direction and supervision, not by the name or form of the contract. The professors said the appellate court had instead denied worker status on the grounds that no employment contract existed and that the training was a mandatory requirement for obtaining a national license.

"If the tasks the trainee performed were repetitive and simple to a degree that made it difficult to characterize them as educational, the court should have carefully examined whether the hospital was in effect using her labor to reduce its staffing costs," the two professors said. They added that the court should have focused less on formalities such as whether a consignment agreement existed, and more on whether the clinical training was conducted in line with its educational purpose and whether the trainee had provided substantive labor under the hospital's direction and supervision.

The concern mirrors guidance issued by the Ministry of Employment and Labor on determining the legal status of and protections for work-experience trainees. The ministry has set out a standard under which a trainee may be regarded as a worker under the Labor Standards Act if an organization repeatedly directs the trainee to perform tasks based on operational need — without a structured job-training program — and is in effect making use of the trainee's labor.

Some regulatory improvements have been made, however. Nursing law enforcement rules enacted last year allow up to 234 of the 780 required hospital training hours to be replaced with practical instruction at government-designated training institutions, easing somewhat the burden of long-hour, hospital-centered clinical placements.


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