Was the 2,000-student expansion of medical schools built on sand?

The expansion was handled, critics said, like a street vendor dividing goods at will rather than as a serious policy decision grounded in educational capacity.

Joo Jung-wan

The author is an editorial writer at the JoongAng Ilbo.

The recent audit by the Board of Audit and Inspection on the push to expand Korea’s medical school quota by 2,000 seats revealed findings that were surprising even to those who expected problems. The report reads almost like an absurdist drama. The previous Yoon Suk Yeol administration’s confident assertions about “scientific evidence” for adding 2,000 medical students turned out to have no basis. What emerged instead was a pattern of arbitrary calculations and political pressure that ultimately hastened the administration’s collapse.

Protesters picket in Yeouido, western Seoul on March 4, 2024, to oppose the governmental plan to increase the country's medical school enrollment quota by 2,000 slots. The demonstration was led by the Korean Medical Association. [YONHAP]

The timeline begins in June 2023, when Cho Kyoo-hong, then minister of health and welfare, first presented a concrete expansion figure to former President Yoon. The number was 500. During the audit, Cho said he had referred to the previous Moon Jae-in administration’s proposal to add 400 students. Yoon reportedly responded by saying that the increase should be “at least 1,000.”

Medical students attending Pusan National University's School of Medicine picket at the main hall of the university in Busan on May 9, 2024. [NEWS1]

Four months later, in a second report, Cho raised the number to 1,000. Yet, Ahn Sang-hoon, then-senior presidential secretary for social affairs, objected, saying that the president “might be upset” by such a small figure. Cho altered the plan again, now recommending an initial expansion of 1,000 seats followed by an additional 1,000 three years later. Yoon then instructed him to “increase it sufficiently.” Cho later told auditors that he struggled to understand what “sufficiently” meant.

Only at that point did the Health Ministry begin searching for research to support a large increase. The conclusion — “a shortage of 10,000 doctors by 2035” — was reached by combining findings from three academic papers. But the ministry ignored each study’s stated caveats, including how projections would vary depending on assumptions about the pace of medical innovation. The authors of the cited papers later publicly opposed the plan to add 2,000 seats. The Board of Audit and Inspection found that the ministry’s projection lacked “logical coherence.”

A pivotal meeting followed in December 2023, chaired by Lee Kwan-sup, then senior presidential secretary for policy. Cho still believed a gradual increase was necessary to reduce resistance from the medical community. Lee disagreed. After the meeting, he privately told Cho that raising the quota by 2,000 “all at once in the first year” would be preferable. That moment marked the first appearance of the 2,000-student figure.

Cho then presented former president Yoon with two options: a phased increase or a one-time expansion of 2,000. Yoon reportedly responded that medical associations would oppose both plans and argued that adding more seats in 2027 — the year of the next presidential election — would be politically difficult. The decision to increase the quota by 2,000 at once was therefore explicitly political.

The official approval came from the Health and Medical Policy Review Committee on Feb. 6 last year. Four members spoke against the 2,000-seat proposal, but Cho pushed the decision through, telling the committee that reporters were “waiting outside.” The deliberation was perfunctory, and the vote was procedural rather than substantive.

The allocation of new seats to individual universities revealed further inconsistencies. Chungbuk National University, for example, received the lowest score nationwide — 18 out of 30 points — in an evaluation of clinical training conditions. Yet, it was given the largest increase, an additional 151 seats. The university proposed opening a hospital branch in Chungju by 2029, but the Korea Institute of Medical Education and Evaluation warned that even under ideal conditions the facility would not be completed until 2031. The expansion was handled, critics said, like a street vendor dividing goods at will rather than as a serious policy decision grounded in educational capacity.

The former Yoon administration’s push for a 2,000-seat expansion left lasting confusion and division across society. The number itself was never a “gold standard” that justified the political and social cost. This does not mean medical school expansion is unnecessary. It means that the guiding principle in discussions about quota increases must be the public’s right to health care, not political strategy.

People walk outside a medical school in Daejeon on July 8. [KIM SUNG-TAE]

The quality of medical education is also a nonnegotiable matter. When training that concerns human life becomes diluted, the public bears the consequences. People want competent doctors, not graduates who barely fulfill course requirements. Korea cannot afford to repeat the previous administration’s pattern of forcing through large-scale policy changes without evidence, consultation or regard for the disruptive impact on society.

The debate over medical school quotas will continue, but any future plan must begin with defensible data, transparent reasoning and an unwavering focus on patient care. Korea needs more doctors in key fields and underserved regions, yet the path to that goal cannot be constructed through hasty projections or political calculations. Only a credible, evidence-based reform process can restore public trust and secure lasting improvements in the health care system.

This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.