THE PEOPLE Power Party announced a significant expansion of the annual medical school enrollment quota by more than 1,000 slots. The Korean government aims to put this decision into effect in 2025[1]. This proposal intends to tackle a looming shortage of physicians in the country and the sharp regional disparity of medical services. The government is encountering massive protests from Korean doctors and medical school students for its enrollment proposal, inciting a heated debate across the entire nation.

Status quo of Korea and the government’s decision

   A medical doctor has traditionally been the most prestigious occupation in Korea, as the medical profession is considered one of the most valuable and competitive positions to obtain. A medical degree has long been the top choice for students seeking university admissions due to the considerable salary and high respect the medical profession receives[2]. Thus, the government’s decision to increase medical school quota has sparked intense controversy amongst the Korean population. The Yoon administration justifies this decision by citing the aging population and doctor shortages in Korea while the Korean Medical Association (KMA) states that merely expanding the number of doctors will not directly tackle problems in the long term. Despite voiced concerns, the Yoon administration has still decided to expand the medical school enrollment quota.

   Korea's quota for medical school students has been very limited compared to other majors. According to the Ministry of Education, there are a total of 40 medical schools across the country and the total admission quota has remained unchanged at 3,058 students annually since 2006. According to data from the Organization for Economic Cooperation and Development (OECD), in 2021, South Korea had 2.1 doctors for every 1,000 individuals, which is below the OECD average of 3.7 doctors per 1,000 people[3]. This discrepancy is even more pronounced in rural areas. In the past five years, the number of people around the country seeking medical treatment in Seoul has climbed up to 1 million, due to insufficient local medical infrastructure[4]. As a result, patient villages emerged, where severely ill patients from rural areas reside in officetels and guesthouses near Korea’s Big Five  hospitals located in or near Seoul. This is attributed to the lack of local medical infrastructure that prevents proper treatment of severe illnesses, demonstrating how addressing the absolute shortage of doctors is critical for the well-being and stability of the Korean population[4]. Thus, the government hopes to address the serious shortage of surgeons, obstetricians, and pediatricians in the country by establishing new local medical schools and expanding the admission quota of pre-existing schools. 

   However, the KMA believes that this issue can be resolved through means other than merely increasing the number of medical students, believing that the declining population and the consequent accessibility to medical care will make the quota expansion an unnecessary decision. Instead, the KMA contends that the solution should involve improving compensation for doctors in critical medical fields and underserved rural regions, rather than merely raising the number of doctors available[3]. In an urgent KMA gathering in Seoul, the association spoke out against the Yoon administration’s unilateral decision-making process. The KMA urged the government to uphold its promise made in 2020, during Moon’s administration, to consult the group on this issue and establish a collaborative dialogue for a fundamental, effective solution.  

Concerns with expanding the enrollment quota 

   The Seoul Medical Association conducted a poll targeting its members regarding the recent decision made by the Yoon administration. A total of 7,972 members including interns, residents, professors, and general practitioners participated in the survey and 77% of the participants opposed the expansion of the medical school enrollment quota[6]. Regarding the reasons for opposition, approximately 95% cited that expanding medical school admissions is not the solution to addressing issues in healthcare, reflecting the grievances of the KMA on the working environment of the doctors in rural regions that worsens inequality in healthcare accessibility[6]. 

   Additionally, 56% cited that the oversupply of doctors will lead to a rise in medical health costs, damaging the national healthcare system[6]. The medical system has a unique consumer and supplier relationship, with doctors being in a position of authority as the providers of medical care. This gives doctors a substantial advantage in terms of their expertise and access to critical information, which often overrules patients' autonomies in making healthcare decisions. As a result, in some instances, doctors have been accused of leveraging their authority to provide medical services—that are not strictly necessary—for more profit. This relationship is often referred to as "supplier-induced demand" and is characterized by healthcare providers influencing or even pressuring patients into accepting unnecessary services or treatments. As such, the public may become vulnerable to over-treatment and hence bear increased financial burdens and the risks of unnecessary medical procedures[7]. 

   Regarding another reason for opposition, 48% put forward their concerns about the weakening of the national science and engineering industries due to the departure of Science, Technology, Engineering, and Mathematics students to the medical field[5]. Many different fields of study in Korea are already noticeably sidelined due to the students’ exclusive preferences for medical schools over any other majors. Even the students enrolled at prominent universities are preparing to drop out of school and take the College Scholastic Ability Test again to gain admittance to the colleges of medicine, dentistry, or oriental medicine that require higher grades[8]. This pronounced preference for the medical profession in Korea is expected to exacerbate with the increased medical school quota. Experts show unease on how Korea’s science and industry sectors will decline as a result of the expanded quota. In fact, according to a poll conducted by MegaStudy Education in April, 21.6% of students chose medical science as their desired major[6]. This shows how Korea, in the near future, might face shortages of talent in other areas—such as engineering, arts, social science, and education—which will undermine the investment and attention that the areas need for progress[8]. Addressing this issue is essential to ensure a more balanced and diversified workforce but the prospect for Korea’s medical field does not seem too bright. 

*                 *                 *

   Korea’s aging population and regional inequalities have again reiterated the need to supply more doctors to ensure the health necessities of the population. To address this doctor shortage, the Yoon administration has announced a significant expansion of medical school enrollment quotas starting in 2025. However, the KMA, along with preexisting medical school students, are exhibiting great hostility against this decision. Through mass strikes and conferences, they are contending that the government should first improve the compensation for doctors in medical fields facing shortages and of underserved rural regions. 
 

[1] Medical Observer

[2] The Hankyoreh

[2] The Korea Herald

[3] The Korea Times

[4] Medi:Gate News

[5] Doctors News

[6] Yonhap News Agency

[7] The Straits Times