[Takryucheongron] The Shortcut to Raising the Nation's Health Level

How Should We View the Expansion of Medical School Quotas?

The government announced that starting from 2022, it will increase the medical school quota by 400 students annually for the next 10 years, totaling 4,000 students. Of these 400 students, 300 will be trained as regional doctors working in local areas, 50 as medical scientists, and the remaining 50 as specialists in underserved fields such as pediatric surgery and infectious diseases. The medical community's opposition to this plan can be summarized as follows: even if the quota is expanded in 2022, new doctors will only enter the market after 10 years; since the population is expected to decline from 2029, there will be no shortage of doctors; increasing the number of doctors will raise medical expenses borne by the public; and the current shortages of regional doctors and specialists in certain fields, which the government points out, cannot be resolved simply by increasing the quota.

We will examine the validity of the medical community's claims. First, the current shortage of doctors. According to data from the Organisation for Economic Co-operation and Development (OECD), the number of doctors in South Korea is about 2.3 per 1,000 people, which is approximately 67% of the OECD average of about 3.5. The number of medical institution visits and hospital stays per capita in South Korea is more than twice the OECD average. Assuming the intensity of services provided per patient is similar, Korean doctors endure more than three times the labor intensity compared to doctors in other countries on average. Naturally, consultation time per patient is inevitably short, which can affect the quality of medical care. The medical community argues that this is due to low medical fees and can be resolved by increasing fees; however, excluding fees from consideration, it is clear that the current number of doctors in South Korea is insufficient in various aspects.

Second, if there is a shortage of doctors, how much should the quota be increased? There is no absolute standard. Even abroad, excessive supply of doctors can cause unnecessary costs, so most countries manage medical school quotas at the national level. The criteria for judgment could be regions or specialties where necessary services are not adequately provided. Currently, in urban areas of South Korea, there is no significant difficulty in accessing services. However, in South Korea's healthcare system, where services are supplied according to market principles, doctors naturally tend to avoid areas with low population density. Consequently, public medical institutions also face difficulties in securing doctors, creating a need for medical personnel to provide services in local areas. To supply regional doctors to essential medical service gap areas by district, the government announced the plan to expand medical school quotas. Since excessive supply could cause unnecessary costs, it is understood that the minimum number per district was estimated. Essential personnel such as pediatric surgeons, infectious disease specialists, and epidemiologists are also reported to be in short supply.

Third, changes in the medical environment require more doctors. Since 2017, the Resident Act has been revised so that residents cannot work more than 80 hours per week. Previously, they worked over 110 hours, so the gap must be filled. Fortunately, the inpatient specialist system is currently in a pilot phase and is expected to transition to a full program by the end of this year. Additionally, rapid aging increases medical demand. According to Statistics Korea, the absolute population will decline in 2029. However, due to aging, medical demand is expected to increase by more than 1.2 times compared to now by 2030.

Expanding the medical school quota will not solve all problems as the medical community claims. Issues such as the appropriateness of medical fees, resident education, and doctors' working conditions remain. Naturally, these must be improved one by one. The answer lies in dialogue and communication. Ultimately, all of this aims to improve the health level of the public.

Shin Young-seok, Senior Research Fellow, Korea Institute for Health and Social Affairs

This content was produced with the assistance of AI translation services.