2,000 vs. 350: what number is appropriate for med school quota hike?
70% of trainee doctors submit resignations; 44% of students apply for leave of absence
The government and doctors are in a fierce standoff over two pivotal questions: whether the country is experiencing a shortage of doctors, and whether the government’s decision to increase the annual enrollment quota at medical schools by 2,000 slots next year is justified.
Doctors’ groups dispute the government’s assessment that the country will face a shortage of approximately 15,000 doctors by 2035. They argue that declining birthrates and readily available access to medical services contradict that prediction.
The heads of medical schools suggest 350 as the more appropriate number of new slots if the quota must be raised, saying that adding 2,000 slots at once is excessive and could adversely affect the quality of education and training.
The government countered these assertions, emphasizing that the decision to raise the medical school admissions quota by 2,000 is deemed a minimal increase. Moreover, it stated that this decision is “irreversible” and essential to address shortages of doctors while enhancing public access to medical services.
While both sides are heading for a collision course and showing no signs of backing down, more than 70 percent of trainee doctors have submitted their resignations to protest the government’s policy. These mass resignations have led to the cancellations of planned surgeries and other significant inconveniences for patients.
President Yoon Suk Yeol made it clear that the plan to increase the annual enrollment quota by 2,000 from the current 3,058 meets only the minimum requirement and still falls “far short” of the required number.
“Previous governments have failed to increase the quota by even one,” Yoon said during a Cabinet meeting.
“We all know that the collapse of essential treatment fields in underserved areas cannot be resolved through the medical school quota hike alone. But it is obvious that the quota hike is a prerequisite for preventing such a collapse.”
The total admissions quota of the 40 medical schools in Korea has remained unchanged at 3,058 since 2006.
When announcing the decision for the quota hike on Feb. 6, the Ministry of Health and Welfare said the country is expected to need 15,000 more doctors by 2035 due to growing demand for health care spurred by an aging population.
The ministry said that 2,000 slots will be added to the annual enrollment quota next year and last at least until 2029. Through those steps, the ministry believes the country will have 10,000 more doctors by 2035.
Regarding concerns that the quota expansion would compromise the quality of medical education and training, Second Vice Health Minister Park Min-soo said that the number of students at Seoul National University’s college of medicine, which was 260 in 1980, has almost halved to 135 at present.
“Similarly, the number at Pusan National University’s School of Medicine, which was 208 in 1980, now stands at 125. On the other hand, the number of professors has increased. Educational conditions have improved a lot compared to the past,” Park said.
But the Korean Medical Association (KMA), the nation’s largest coalition of doctors, and other related groups disagree.
They said the government should consider that the population decline is being caused by low birthrates and that people now have easier access to local clinics.
“The number of newborns is falling. Even if the government maintains the current medical school enrollment quota, the relative number of doctors will increase,” said Lee Dong-wook, who heads the KMA’s Gyeonggi Province branch.
“Moreover, Koreans utilize medical services at a rate 2.5 times higher than the OECD average, indicating an existing oversupply of medical services in the country.”
A pediatrician who runs a local clinic in Seoul’s Dongjak District emphasized that a more pressing priority for addressing the deepening regional disparities in medical services is to allocate doctors and patients more effectively. Additionally, improving the working environment for physicians operating under challenging conditions is crucial.
“I think raising the medical school quota is not an urgent priority,” he said on condition of anonymity.
The Korean Association of Medical Colleges (KAMC), representing deans of medical schools nationwide, has urged the government to reconsider its decision. They argue that accommodating an additional 2,000 slots in 40 medical schools within a short timeframe is unfeasible, especially given the current educational conditions.
During a press conference, Monday, the association said it would be more appropriate to add 350 slots to the annual enrollment quota instead of the full 2,000. The association, however, did not offer any explanation or justification for why 350 is a more appropriate number.
Power-to-power confrontation
While the government and doctors have traded barbs, concerns over public health have heightened, with a total of 8,816 trainee doctors, or 71.2 percent of all such doctors, having submitted their resignations in protest as of Tuesday. Of them, 7,813, or 63.1 percent, have left their worksites.
Hospitals affected the most include the so-called “big five” in Seoul — Seoul National University Hospital, Seoul Asan Medical Center, Samsung Medical Center, Severance Hospital and Seoul St. Mary’s Hospital — that play a key role in providing medical care for critical patients.
“The government has ordered 6,112 trainee doctors to return to work,” the second vice health minister told reporters during a media briefing, Wednesday.
Despite the government’s hardline stance, including a threat to revoke the medical licenses of those who participate in the walkout, trainee doctors have shown no signs of backing down.
In a statement, the Korean Intern Resident Association, an association of interns and resident doctors, demanded the government go back to square one and withdraw the plan to increase the medical school enrollment quota.
Medical students have also joined the collective action. According to the Ministry of Education, 7,620 students at 27 medical schools have applied for leaves of absence as of 6 p.m. Tuesday. This accounts for about 43.8 percent of the total number of medical students nationwide.
Those who did not apply for a leave of absence are moving to boycott classes, according to the education ministry.