What Will Happen to Rural Healthcare?... 87% of Public Health Centers Expected to Lack Public Health Doctors Next Year

Only 98 New Public Health Doctors This Year, Raising Concerns Over Healthcare Gaps
Sharp Decline in Applicants Due to Long Service Periods and Poor Working Conditions

It is projected that more than 80% of public health centers nationwide will not have public health doctors (Gongbo-ui) assigned next year. As public health centers have served as the last remaining 'local medical facilities' in rural and fishing communities, concerns are growing about potential gaps in healthcare services in medically underserved areas.

According to the report titled "Rapid Decline of Public Health Doctors: What Should Be Done for Medically Underserved Areas," published by the National Assembly Research Service on May 8, and information from the Ministry of Health and Welfare, the number of eup and myeon-level public health centers without public health doctors is expected to rise from 730 locations (59.5%) this year to 1,023 locations (82.1%) next year. By 2027, an estimated 1,083 centers, accounting for 86.9% of all public health centers, are expected to operate without public health doctors.

Typically, one or two doctors are stationed at each public health center, handling the management of chronic diseases such as hypertension and diabetes, as well as the treatment of minor illnesses like colds. However, the public health doctor system, implemented in 1979 to address physician shortages in medically underserved regions, has seen a steady decline since 2010, with a sharp reduction in new recruits in recent years. The number of new public health doctors from medical schools decreased from 449 in 2023 to 249 last year, and dropped further to just 98 this year.

The Ministry of Health and Welfare predicts that if this trend continues, the number of new recruits each year will remain in the 100s through 2031. The main reasons cited for avoiding public health doctor positions include the long service period and poor working conditions. After three weeks of military training, public health doctors are required to serve for 36 months, which is twice the 18-month service period required for active-duty Army soldiers.

Jung Eunkyung, Minister of Health and Welfare, is visiting the Anjeong-myeon Health Center in Yeongju City, Gyeongbuk Province in April, engaging in conversation with medical staff. Photo by Yonhap News

Although the monthly salary is about 2.4 to 2.5 million won, which is higher than that of a sergeant, there are claims that this is not sufficient incentive given the length of service and working conditions. In a survey conducted last year by the Korean Association of Public Health Doctors among approximately 2,500 medical students, about 90% of respondents said they would be willing to serve as public health doctors or military doctors if the service period were reduced.

Issues regarding the work structure have also been raised. While current law stipulates that public health doctors are to perform 'public health work,' the specific scope of their work is not clearly defined. In many cases, personnel are assigned based on administrative districts rather than actual medical demand.

The report noted, "This is consistent with criticism that the system focuses on the assignment itself, leading to the arbitrary performance of public health doctors' work. Experiences during crises, such as their deployment as substitute personnel in response to COVID-19 and the collective resignation of medical residents, have resulted in increased workloads and burdens. These experiences may also have contributed to declining new applications."

Additionally, the report stated, "Differentiated compensation for experience should be considered, such as awarding extra points for future hospital placements when working in underserved areas. It should also be ensured that working as a public health doctor provides an attractive career path for individual doctors, by establishing an environment that allows them to gain clinical experience."

In response, the Ministry of Health and Welfare announced in March that out of 532 public health centers in medically underserved areas, only 139 would be staffed with public health doctors from medical schools, while the remaining 393 would be operated using telemedicine and remote consultation systems. The ministry also plans to have public health officers with nursing licenses take charge of some of the clinical duties.

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