South Korea is well known as one of the most developed countries in the world regarding medical technology and health insurance policies. However, the South Korean government is pushing for the expansion of the medical school quota to address growing medical demands. This has caused ongoing conflicts with the medical community since the matter was first raised years ago.
In 2020, South Korea’s former President Moon Jae-In’s government called for a national increase in the medical school quota, but the policy was discarded due to strong opposition from healthcare providers and medical students. Reigniting the issue, the current government first proposed an increase in the quota last October. The plan has been upheld in the face of intensifying conflict.
On Oct. 19, 2023, the South Korean government announced its strategy for innovating essential medical services and securing sufficient medical personnel across the nation. True to its word, on Oct. 26, the Ministry of Health and Welfare proposed an expansion of the number of medical schools through the process of conducting surveys and the operation of inspection teams, while also preparing essential medical policy packages.
The medical community has strongly opposed the policies, with the Korean Medical Association (KMA) stating that if the government unilaterally pushes for expanding medical school capacities, the association will increase the intensity of opposition by holding regional and nationwide doctors’ rallies. However, Minister of Health and Welfare Cho KyooHong strongly criticized the KMA. Moreover, Minister Cho warned that the ministry would issue an order to recommence work under Article 59 of the Medical Service Act, which can legally compel doctors to return to work in case of a strike.
Despite the public dissent from medical professionals, on Feb. 2, Minister Cho confirmed the increase in the medical school enrollment quota by 2,000 starting in 2025. Nearly 3,000 students are currently enrolled in medical schools, a figure that has remained static since 2006. Minister Cho stated that the government had received data demanding more physicians and educational capabilities from 40 universities, and that it plans to accordingly increase the number to reach 10,000 by 2035.
People who side with the government’s opinion cite comparisons between South Korea and other countries. According to DONG-A ILBO on Feb. 19, the ratio of physicians to the national population in Germany, France, and Japan in 2021 was higher than that of South Korea as they had increased the number of medical students. Similarly, Korea JoongAng Daily reported that the United Kingdom had increased its number of doctors and nurses in the last five years and that the United States has built 30 new medical schools.
On the other hand, grounds of opposition could be found in a recent Chosun Ilbo interview with Woo Bong-sik, director of the KMA’s Research Institute for Healthcare Policy. Woo said that there are enough physicians in the field as there have not been any retirements while new medical school students continue to graduate each year. The increase in the school quota will proportionally cause an increase in demand, which can shake related financial systems such as health insurance. Woo also pointed out the contradictory nature of the government’s logic, stating that an increase in medical schools cannot guarantee an increase in local healthcare but instead raise concerns over of poor-quality education, because the current infrastructure will not be able to support the sudden student influx.
In line with these concerns, according to BBC Korea’s report on Feb. 23, the Korean Intern Resident Association announced a statement calling for the complete abolition of the plan. As of Feb. 22, nearly 80 percent of interns and residents had turned in their resignations at 94 hospitals. Responding to the impending crisis, the Ministry of Health and Welfare issued a medical maintenance order that prohibits collective actions of medical personnel with possible license suspension as a consequence of the violation.
Students who are currently attending medical schools have also demonstrated their dissatisfaction with the premises. According to a Ministry of Education announcement dated Feb. 29, 13,698 students, accounting for 72.9 percent of medical students nationwide, submitted a leave of absence at once on Feb. 20. In addition, 40 medical schools, including those associated with Asan Medical Center, Samsung Medical Center, Seoul National University Hospital, Severance Hospital, and Seoul St. Mary’s Hospital, dubbed the “Big 5” hospitals, issued statements claiming that the quota expansion is an ineffective policy that should be canceled.
However, according to a report by Yonhap News on Feb. 29, the government has firmly maintained its stance that students’ requests cannot be accepted, as it is not legitimate to boycott their academic obligations in opposition to government policy. Universities have been asked to promptly encourage students to cancel or reject applications for leave that do not meet the formal requirements. If group boycott activities continue for a prolonged period, students may face collective academic suspension.
Meanwhile, due to the resignations of residents and interns that have resulted in the lack of medical personnel in hospitals, the number of patients not being treated properly has been increasing, causing anxiety and inconvenience nationwide. The Hankyoreh reported that the Big 5 hospitals had to cut 30 to 50 percent of their scheduled surgeries and medical treatments on Feb. 26.
According to a Korea Alliance of Patients Organization survey of its members conducted between Feb. 26 and 29, a total of 13 cases of damage were reported. Examples included postponements of a Fontan operation and a hematopoietic stem cell transplant, as well as a case where a patient was unable to receive anticancer therapy, leading to significant decline in his chances for survival. Citing these examples, the group submitted a petition to the National Human Rights Commission of Korea, claiming the inconvenience and anxiety experienced by patients to be human rights violations, and issued a statement urging the residents and interns to return to work. In addition, an organization of patients suffering from severe illnesses held a press conference at the National Assembly on Feb. 29, criticizing both the medical community and the government.
As the debate drags on and tensions start to build, both sides are continuing to make controversial remarks regarding the quota expansion. These remarks have drawn harsh criticism from all parties, including the public.
In a Yonhap News report dated Feb. 22, Lee Dong-wook, head of the Gyeonggi Provincial Medical Association claimed, “The public does not want students ranked 20 to 30 in their class to be accepted into medical school.” Subsequently, many people have criticized the elitism of the medical society conveyed by this statement.
Joining the controversy was a statement by a government official, angering trainees and physicians over sexist claims. A Yonhap News report on Vice Health Minister Park Min-soo’s Feb. 20 briefing quoted him as saying, “We have analyzed the increase in female doctors and the difference in working hours between male and female doctors.”
The next day, the student council of Ewha College of Medicine uploaded a statement on their Instagram account, maintaining that Park’s claim amounted to a blatant sexist attack against all female healthcare workers. Afterward, Yonsei University, Korea University, and 26 more schools banded together in support of the statement. Also, seven female medical committees have sued Vice Minister Park for defamation.
In addition to such statements, remarks by medical school faculty have also generated controversy. Amid prolonged opposition to policies affecting medical students, Jeong Eun Kim, Dean of Seoul National University College of Medicine, emphasized the social responsibility of doctors at a graduation ceremony held on Feb. 27. Kim stressed that graduates should consider the public’s perspective, and that they should not focus on upholding high economic statuses and instead fulfill their social responsibilities.
As healthcare is a vital and sensitive issue nationwide, the prolonged dispute between the government and the medical community is adversely affecting the public. With controversy igniting conflict among all stakeholders, there is a pressing need to promptly resolve the issue and minimize potential damage to society. However, given the complexity of the current situation and the need for careful consideration, a speedy resolution of the issue seems unlikely.