Medical School Quota Expanded by 2,000 for the First Time in 19 Years [What Do You Think?]

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As the government pushes to expand the quota for medical schools, medical associations have strongly opposed the move, raising concerns about a potential healthcare crisis. The Ministry of Health and Welfare plans to increase the number of new medical students nationwide by 2,000 starting next year, breaking the 19-year freeze at the quota of 3,058 students. On the other hand, the medical community firmly opposes this, arguing that simply increasing the number of doctors will not solve issues such as regional hospitals and essential medical care coverage, and may lead to a decline in the quality of healthcare.

Both sides recognize the shortage of doctors in regional hospitals and essential medical specialties as a key issue. Although about 3,000 new doctors pass the national medical licensing exam each year, it remains difficult to recruit doctors for regional hospitals. There is also a severe shortage of pediatricians, obstetricians-gynecologists, and emergency medicine doctors. However, the government and the medical community have significantly different approaches to solving this problem.

Two main solutions have been proposed to address the "doctor shortage." ① The first is to physically increase the quota for medical schools to raise the number of doctors, which is the government's plan. ② The second is to improve medical policies (infrastructure and compensation systems) to encourage doctors to work in regional and essential specialties. Considering that even offering annual salaries of several million won does not attract doctors to regional hospitals and that medical service interruptions are frequent, the government believes both approaches should be pursued simultaneously to improve the situation.

However, the medical community argues that ② should take precedence over ①. They claim that expanding medical school quotas could lower the quality of healthcare and exacerbate the commercialization of medical services. Fundamentally, they believe that "increasing medical school quotas → attracting medical personnel to unpopular specialties" does not occur. Park Dan, president of the Korean Intern Resident Association, wrote on his Facebook, "Instead of expecting a trickle-down effect from increasing medical school quotas, we need to pave the way for water to flow in the right direction." He listed methods such as establishing a specialist-centered medical system, increasing medical school faculty, restricting mild patients' use of tertiary hospitals, introducing a 40-hour workweek for residents, raising resident wages, enacting a special law on medical accident handling, and securing necessary funding.

Meanwhile, the government maintains that both ① and ② should be approached as a two-track strategy. Park Min-su, the second vice minister of the Ministry of Health and Welfare, stated, "We have decided to introduce a special law on medical accidents and mutual aid insurance, and through comprehensive medical reforms such as the regional medical development fund, we are working to solve the shortage of doctors alongside expanding medical school quotas."

Source: Ministry of Health and Welfare, 'OECD Health Statistics 2023' data

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The data cited by both sides to argue about the shortage of "clinical doctors" differ significantly. The government bases its claims on estimates from the Korea Institute for Health and Social Affairs (KIHASA) and the Korea Development Institute (KDI). According to the 2021 report "Projection Study on Supply and Demand of Doctors by Specialty," conducted by KIHASA at the request of the Ministry of Health and Welfare, assuming the workload per doctor remains at the 2019 level, there will be a shortage of 14,334 doctors by 2030 and 27,232 by 2035. The number of clinical doctors is also far below the average of the Organization for Economic Cooperation and Development (OECD) countries.

On the other hand, the Korean Surgical Society analyzed statistics from 25 OECD member countries over the past 30 years and presented evidence that a 1% increase in the number of doctors per 1,000 people results in a 22% increase in medical expenses per capita. They argue that increasing the number of doctors will ultimately not bring significant changes in regional and essential medical fields.

Minister of Health and Welfare Cho Kyuhong is leaving after announcing the plan to expand medical school admission quotas at the Government Seoul Office in Jongno-gu, Seoul, on the 6th. Photo by Jo Yongjun jun21@

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Experts are also divided. Kang Ki-beom, former emergency committee chairman of the Korean Medical School and Graduate School Student Association, said at the "Medical School Quota Expansion Continuous Debate" held late last year, "If medical school quotas are increased solely for the financial benefit of university foundations while hospital infrastructure remains unchanged, it could create substandard medical schools." Kim Cheol-hoon, professor of pharmacology at Yonsei University College of Medicine, stated, "If many students enter medical schools, the talent pool for other science and engineering fields such as engineering will be affected," and emphasized the need for a careful national strategy for talent pool allocation.

Meanwhile, public opinion appears favorable toward expanding medical school quotas. According to a survey conducted by Korea Gallup (1,004 respondents, with a sampling error of ±3.1 percentage points at a 95% confidence level) commissioned by Segye Ilbo from May 29 to 30 last month, 78% of respondents supported the government's policy to increase medical school quotas by more than 1,000 students. Only 17% opposed it. By age group, support was highest among those in their 60s at 89%, followed by 50s at 84%, 40s at 79%, 70 and older at 78%, 30s at 75%, and 18-29 at 63%. (For detailed information, refer to the Central Election Poll Deliberation Commission website.)

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