'Doctor X: Mafia in White' rebounds after ratings dip during strike arc

Episode 10 draws 17.7% nationwide, peaks at 20.2% per minute

SBS Friday-Saturday drama series "Doctor X: Mafia in White" [SBS]

In the conference hall, a vote on whether to submit resignation letters is underway among resident doctors. At the same moment, eight-year-old patient Lee Hyeon-a (played by Lee Chae-yu) lies on the operating table. To remove a rare tumor that has spread to her blood vessels and multiple organs, surgeons must extract six organs from her body, repair each one individually and return them. Lead surgeon Gye Su-jeong (played by Kim Ji-won) bows deeply before her colleagues, but no one steps forward. The professors who had long looked down on Gye Su-jeong come to feel, if a little late, the full weight of being a doctor. Hospital Director Bu Seung-gwon (played by Son Hyun-joo) leaves the vote with a single declaration — "Right now, in the biggest operating room in this hospital, the smallest child is having surgery. If you're a real doctor, that's where you should be" — and walks through the OR doors.

SBS Friday-Saturday drama series "Doctor X: Mafia in White" has cleared a major turning point in its medical-strike storyline. According to Nielsen Korea on Sunday, Episode 10, which aired Saturday, drew a nationwide household rating of 17.7% and peaked at 20.2% per minute — up 2.4 percentage points from Episode 9's 15.3%. Among viewers aged 20 to 49, the show averaged 7.2%, holding the top spot across all broadcast channels for five consecutive weeks.

"Doctor X: Mafia in White" brought the resident doctors' strike against medical school enrollment expansion to the center of its plot beginning with Episode 8, which aired Oct. 31. After briefly introducing the government's enrollment decision at the end of Episode 7, Episode 8 depicted residents walking out of Guseo University Hospital, leaving the doctors' lounge empty — a setup that evokes the 2024 standoff between the government and the medical community, when resident doctors en masse abandoned their training hospitals in protest of the enrollment increase.

'If you're a doctor, scrub in' — the OR as one surgeon's stage

The operating room in Episode 8 belonged entirely to Gye Su-jeong. With the residents gone, she invoked a clause in her contract guaranteeing her the surgeries she wanted and declared a "solo surgery" — operating without assistance. It was a 12-hour continuous procedure to save 10-year-old pediatric cancer patient Yoo Ga-eul (played by Ki So-yu), who had already undergone eight rounds of chemotherapy. When Bae Heung-gon (played by Lee Seong-uk) shouted "We're doctors too!", the reply was short and cold: "Then scrub in. If you're a doctor, get in here and operate."

The show does not silence the voices of those who joined the strike. When the doctors who stayed insist that patients come first no matter the circumstances, the striking residents fire back, demanding that their years of hard work not be dismissed. Bae Heung-gon says he supports the strike, yet cannot hide his regret that the junior colleague who walked out never got to witness the surgery.

Even so, the scales tip in one direction. The striking residents' perspective is sketched in a few lines of dialogue, while the camera lingers on the sweat and resolve of those who stayed in the OR. When colleagues point fingers at Park Tae-gyeong (played by Kim Woo-seok) for not joining the walkout, he snaps back: "How can people who don't want their rice bowl taken away call the ones who stayed to save lives traitors?" Do Yun-sik (played by Kim Young-min), who scrubbed in alongside Gye Su-jeong, confesses that "the strike suddenly feels kind of pathetic." It is a direct confrontation with a real-world stigma from the height of the doctor-government standoff — the branding of those who remained at their hospitals as betrayers.

Eight walk out of the vote — from 'alone' to 'together'

By Episodes 9 and 10, the story's center of gravity shifts. In Episode 9, Gye Su-jeong bows her head and asks for a surgical team ahead of Lee Hyeon-a's operation, but no one responds. Hospital Director Bu Seung-gwon holds firm, insisting ethics committee approval must come first. As the vote on resident resignations proceeds, Do Yun-sik slips out of the meeting room and heads to the understaffed OR. When the patient's blood pressure plummets, Jang Hui-suk (played by Lee Jeong-eun) enters in scrubs. Known only as the head of a physician staffing agency, Jang Hui-suk reveals herself to be a surgeon — and Gye Su-jeong calls her a mentor.

In Episode 10, even Bu Seung-gwon and Bae Heung-gon choose the OR over the meeting room. "This is my choice," the director says — and with that, eight people from director to intern gather around a single operating table: Gye Su-jeong, Jang Hui-suk, Bu Seung-gwon, Park Tae-gyeong, Jo Won-jin (played by Lee Jin-hee), Do Yun-sik, Bae Heung-gon and Kim Seong-jin (played by Heo Jun-seok). After an extraordinarily complex procedure — removing organs, excising the tumor and reimplanting them — Do Yun-sik's cry breaks the silence: "Hyeon-a, you made it!"

If Episodes 1 through 8 told the story of one infallible surgeon cutting through injustice on her own, Episode 10 is the story of doctors who once feared failure each making their own choice to act. The drama's answer to the collective choice of a strike is another collective — a team of eight united around one operating table.

The victory does not last. The Mokryeon Society moves to discipline the Guseo University Hospital medical staff, citing the surgery's risks, questions over institutional review board approval and the involvement of an outside physician the hospital had not authorized. Gye Su-jeong receives notice that her contract will be terminated. The disciplinary action is put on hold only after Lee Hyeon-a's mother and Jang Hui-suk pursue legal action.

A dip into the 15% range, then a rebound — the strike episodes by the numbers

Ratings swung sharply during the strike arc. "Doctor X: Mafia in White" opened at 11.4% in its first episode, then climbed steeply to 18.5% in Episode 4 and 19.5% in Episode 6, which covered a story tied to the May 18 pro-democracy uprising. It then fell for three consecutive episodes — 16.5% in Episode 7, 15.6% in Episode 8 and 15.3% in Episode 9 — a stretch that shed 4.2 percentage points from the show's peak and coincides precisely with the strike storyline.

Kim Ji-won in SBS Friday-Saturday drama series "Doctor X: Mafia in White" [SBS]

A shift is also visible in the day-by-day pattern. "Doctor X: Mafia in White" airs on consecutive Fridays and Saturdays, and the Saturday episode had consistently outrated the Friday one. Episode 2 (14.9%) beat Episode 1 by 3.5 percentage points; Episode 4 (18.5%) topped Episode 3 by 3.4 points; Episode 6 (19.5%) edged Episode 5 by 2.0 points. That pattern broke for the first time with Episode 8, which launched the strike arc — despite airing on a Saturday, it came in 0.9 percentage points below Friday's Episode 7. The pattern reasserted itself in Episode 10, when the eight-surgeon operation concluded.

Pinning the ratings decline on a single cause is difficult. The period coincided with a controversy over a petition to halt broadcast of the May 18 episode and the introduction of the politically sensitive doctor-government conflict storyline. Yet given that the per-minute peak in Episode 10 — the climax of the strike arc — exceeded 20%, the argument that contentious subject matter simply drove viewers away does not fully account for the curve.

The medical community's reaction remains cold. Kim Dae-jung, an internal medicine professor at Ajou University School of Medicine, wrote in a social media post titled "Five things I want from 'Doctor X'" that while there is no need to conceal the issue of resident blacklists, the show should also illuminate why residents were driven to abandon their training — the desperation born of unilateral policy decisions and harsh training conditions. The post called on the drama to depict the structural problems of the healthcare system — reimbursement rates, litigation risks and staffing shortfalls — rather than focusing on villainous doctors. Former Daegu Mayor Hong Joon-pyo also wrote on Facebook on Sunday: "No matter how you invoke freedom of expression, what is there to gain from vilifying the medical profession like this?"

Two episodes remain. At the end of Episode 10, a shocking scene showed Park Tae-gyeong pressing a pillow over the sleeping face of Kim Seung-hyo (played by Jeon Guk-hwan). Kim Seung-hyo, who leads an overseas medical volunteer group called "White Wings," had addressed Gye Su-jeong as "Doctor X," opening a door to a hidden past. The question the final episodes must answer is the true meaning of that name. In Episode 9, Jang Hui-suk offered this definition: "A doctor who puts the patient's life and well-being above all else and gives everything to every surgery — if that is Doctor X, then Gye Su-jeong is Doctor X."

shee@heraldcorp.com