Public Health Doctors Reduced to a Quarter in 10 Years... Priority Deployment to Medically Underserved Rural Areas

Due to the training gap of medical residents and the suspension of medical student education caused by the conflicts between the government and medical associations in 2024 and 2025, the number of public health doctors (PHDs) has sharply declined. In response, the government is reorganizing the functions of public health centers in medically underserved areas and expanding telemedicine to fill the gaps in regional healthcare.

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The Ministry of Health and Welfare announced on the 13th that, in view of the recent rapid decrease in PHDs, it has judged the situation as a regional healthcare crisis and formulated emergency measures focused on the prioritized assignment of PHDs and the activation of mobile clinics in medically underserved areas.

According to the Ministry, the number of PHDs, which stood at 2,116 in 2017, dropped dramatically to 945 last year and just 593 this year. In particular, only 98 new PHDs were recruited this year, which is just 22% of the 450 PHDs whose service terms have ended.

The main reasons for this sharp decline in PHDs are: the widening gap in service periods compared to active-duty soldiers, the increase in the proportion of female students in medical schools, and collective military leaves of absence among medical students due to ongoing conflicts between the government and medical associations over the past two years. The government expects that the difficulties in regional healthcare due to PHD shortages will persist until 2031.

In response, the Ministry of Health and Welfare has decided to implement a range of measures developed in consultation with local governments to prevent regional healthcare gaps caused by the decrease in PHDs.

First, through an analysis of medical vulnerability, the government will identify medically underserved areas at risk of healthcare gaps and apply intensive measures there. Medically underserved areas are defined as regions within administrative districts that lack medical institutions (clinics or higher) and pharmacies, and are also more than 4 kilometers away from the nearest medical institution in adjacent towns or townships. Currently, an analysis of distances to private medical institutions at the township level found that there are 547 towns and townships nationwide (532 with public health subcenters) where there is no private medical institution within the area or adjacent regions, indicating poor medical accessibility.

Among these, 139 public health subcenters in remote or isolated areas, such as islands and mountainous regions, which lack or are far from private medical institutions, will be prioritized for PHD placement. For the remaining 393 public health subcenters without PHD assignments, local governments will reorganize functions according to local medical conditions to ensure continued medical services.

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Nurse public health officers will be assigned in place of doctors to perform basic medical services, such as prescribing 91 types of medicines and administering vaccinations, or the centers will switch to a system where nearby public health center doctors visit regularly for mobile clinics. In particular, for elderly residents in rural and fishing villages, the government will implement a "vulnerable area telemedicine model," where public health center staff assist with telemedicine, and will actively introduce AI-based systems to support diagnosis and remote collaboration.

To secure physician manpower, the government will expand the "senior doctor support program," which hires retired medical specialists over the age of 60, and the "contract-based regional essential doctor system," which provides settlement support on the condition of long-term work. It will also activate mobile and dispatch medical services at regional healthcare institutions, such as provincial medical centers, and continue to pursue the longstanding issue of shortening military service periods to encourage more PHDs.

Given that PHD shortages are expected to continue for several years, the regional public healthcare system will also be restructured. Through innovative projects that invest in regional areas, the government will focus on securing medical personnel and building networks in vulnerable regions. It will further strengthen the concentration and hub function of medical resources, and enhance outreach medical and care services to establish a comprehensive, regionally centered primary healthcare system. This will create a foundation for newly trained doctors under the regional doctor system to be efficiently assigned and work at local public healthcare institutions.

In addition, with the nationwide implementation of integrated medical, nursing, and care support scheduled to begin on the 27th, the government will reorganize the roles of local public healthcare institutions to ensure that prevention, treatment, and care services are provided without disruption at the closest point to rural residents. The roles and competencies of nurse public health officers will also be strengthened.

Minister of Health and Welfare Chung Eunkyung emphasized, "With the ongoing changes in policy conditions, such as regional extinction and integrated community care, and the sharp drop in the number of PHDs, restructuring the regional public healthcare system is now an urgent task that cannot be postponed any longer." She added, "We will mobilize all available resources to build a robust healthcare safety net so that residents in vulnerable areas can receive medical care with peace of mind wherever they are, and use this as an opportunity to innovate toward a sustainable regional healthcare system."

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