Is the 2,000 quota hike really irreversible?

The medical community and the government must have dialogue now.

President Yoon Suk Yeol on Sunday ordered the government to take a flexible approach to the trainee doctors on walkout to protest the government’s plan to hike the enrollment quota for medical schools. They were supposed to be stripped of their licenses to practice medicine from Monday if they don’t present convincing reasons why they cannot return to their hospitals. We hope the medical community and the government find a breakthrough in the deadlock.

The conflict all started with the government’s sudden announcement of the increase. The government based the decision on the numbers of doctors and medical school graduates per 1,000 people — 2.6 and 7.2, respectively — which are even lower than the OECD averages at 3.7 and 14.2. The government attributes the collapse of essential medical departments and regional medical services to the numerical disparity.

The health and welfare minister asserted last month that if 2,000 more students are admitted to medical schools annually from 2025 to 2031, Korea will have 10,000 more doctors than now.

The basis for the expectation was three reports from a Seoul National University professor, a KDI researcher, and an expert from an institute. The three reports commonly anticipated a lack of 10,000 doctors by 2035 if the current quota is maintained. But there are diverse factors behind the demand for more doctors, including the pace of the aging population and medical technology advancement. A KDI report stipulated that an incremental annual increase of 5 to 7 percent will be the most rational.

But the presidential office is convinced that the decision is up to the government. Is the 2,000 increase really an irreversible decision?

Other countries also increased their quotas, but not as steeply as Korea’s 66 percent at one time. For instance, Japan lifted its quota by 23.3 percent over seven years starting in 2007, Britain by 58 percent over eight years and the United States by 39 percent over 12 years. Japan increased the number bottom-up, a drastic difference from Korea’s top-down.

The government allotted 82 percent of the increased quota to medical schools in regions other than Seoul to narrow the gap in medical services. But the problem is a lack of medical professors and facilities needed to educate them whether it be medical schools or hospitals running internship programs.

OECD data shows that 43 per every 100,000 Koreans died without receiving appropriate medical care, but the number was 89 for OECD. Koreans also receive diagnosis and treatment twice more than those in the OECD. That suggests Koreans receive better medical services than their counterparts in Europe. But doctors in essential medical services tell a different story. In 2022, the department of pediatrics, for instance, was only 28 percent full due to students’ avoidance, citing low insurance coverage. The coverage rate of angina is only one-tenth of the United States. Who would enter such vital areas in the future?

To fix the problem, such medical cost should be 100 percent covered by national insurance. Without it, medical students will continue shunning such vital fields. The government must frankly tell the public about the cost burden. The government announced its detailed allocation plan to each university. But the battle is not over yet, as we have to wait until each university announces their own admissions guideline in May. The medical community and the government must have dialogue now.