Doctors’ group to “fight” government plan to increase medical school quota by more than 1,000

Participants shout slogans at an emergency meeting of medical representatives to respond to a higher medical school enrollment quota organized by the Korea Medical Association (KMA) at the KMA building in Yongsan-gu, Seoul on October 17. Yonhap News

The government is expected to announce a plan to increase the quota for medical school admissions by over 1,000 students starting with the college admissions for the 2025 school year this week. It will be an “emergency prescription” to resolve the aggravating absence in regional and essential medical staff. Opposition from doctors’ organizations is expected to the larger-than-expected increase.

According to the coverage by the Kyunghyang Shinmun on October 15, the Ministry of Health and Welfare will hold a strategy meeting on innovations for complete essential medical services outside the Seoul metropolitan area on October 19. In the meeting, the government is expected to finalize and announce the raised quota for medical school enrollments for the 2025 school year. Some expect President Yoon Suk-yeol to personally make the announcement. The People Power Party (PPP) and the government held a meeting of senior government and PPP officials Sunday night and discussed related issues.

Much of the attention is on the size of the increase. Restoring the quota by an increase of 351, which is how much the quota was reduced when drug prescribing and dispensing was separated in 2000, and increasing the quota by 500 centered on national universities have been mentioned, but recently, some predicted that the government would increase the quota by over a thousand. According to related officials, President Yoon is determined, and the Office of the President gave instructions to the health ministry.

The medical school admissions quota has remained at 3,058 since 2006. In the last few years, the problem of medical refugees--patients from outside the Seoul metropolitan area going to a hospital in the greater Seoul area to receive treatment--has grown worse, and this year, a number of patients died while circling emergency rooms for treatment. Authorities believe it was because there is a shortage of doctors outside the capital area and in essential medical departments. According to the “OECD Health Statistics 2022,” the number of clinical doctors for every one thousand of the population in South Korea was 2.5 as of 2020, which falls short of the OECD average (3.7).

Demand for medical services has increased due to an aging society, and one study concluded that the shortage of doctors would soar from 14,334 in 2030 to 27,232 in 2035 (Korea Institute for Health and Social Affairs, 2021). Britain, which has a population similar to that of South Korea, welcomed 8,639 students into medical school in 2020.

As for how the government will increase the medical school enrollment quota, it is likely for the government to transfer the hospitals of national universities, which is currently under the jurisdiction of the education ministry, to the health and welfare ministry and significantly increase the admissions quota in national university medical schools. The government is also reviewing a “local doctor system,” mandatory service in particular regions for a certain period of time. But since it restricts the doctor’s right of choice, the effectiveness of the policy is questionable. Some politicians and civic groups are asking the government to newly establish public medical schools outside the Seoul metropolitan area, but it is unlikely to be realized. In a parliamentary inspection on October 11, Minister of Health and Welfare Cho Kyoo-hong said, “We will review establishing a public medical school, but personally, I think we need to be cautious.”

Even if the medical school quota is raised, it will take over ten years for the newly admitted students to be assigned to work in hospitals. The Korea Medical Association (KMA) argued that there was no shortage of doctors and that resolving the imbalance in placements should be top priority. The government is expected to respond by announcing a package of policies, such as expanding support and increasing the infrastructure for regional and essential medical services, improving the working environment of residents, expanding the admission of talented local students in local medical schools, and reducing the service period of public health doctors.

A representative of the Korea Medical Association said, “They make it look like doctors are only trying to secure their interests, but the older generation of doctors could probably secure their interests in advance,” and argued, “If we only increase the medical school quota without solving the problem of doctors avoiding regional and essential medical services, it will only aggravate the competition to get into medical school, leading to students making second and third attempts to get in, and threatening science and engineering majors even further. It’s a decision that has not taken these side effects into consideration.”

The KMA representative continued and said, “The medical school admissions quota is an issue that the government promised to discuss with the KMA in a consultative body on medical issues in an agreement between the government and doctors in 2020,” and added, “KMA executives had participated in communications despite internal criticism, but if the government pushes ahead and announces its plan without an agreement, then a protest will be inevitable causing major chaos in hospitals.”

Members of the doctors’ group are also speaking of a strike. In 2020, when the government tried to increase the medical school enrollment quota and establish a public medical school, doctors including residents went on a general strike and collectively refused to see patients. Some medical school students refused to take the national examination for medical licenses.

Even if the KMA decides to go on strike, the impact of the strike will be determined by whether professors and residents of university hospitals and upper tier general hospitals join the strike. There are many doctors who are also in favor of raising the quota for medical school after work intensity increased due to a shortage in personnel in major hospitals. Some believe residents will not oppose the higher quota too much as long as the government does not promote the local doctor system and establish a public medical school. However, it is uncertain as to how they will accept an increase of over a thousand, more than twice the original estimate. Also, if the government leaves out the establishment of public medical schools, politicians and civic and labor groups could oppose the government plan.