[Editorial] Greater cause

Medical schools across the country will admit 2,000 more students starting from the next school year, raising the total annual quota to 5,058, the Ministry of Health and Welfare said Tuesday.

The planned increase in the number of people trained as physicians comes as South Korea suffers from a deadly shortage of doctors outside the greater Seoul area and in life-saving specialties such as pediatrics, general surgery, cardiothoracic surgery and emergency medicine. The government plans to revise the national health insurance system to raise its payments for what the government terms essential healthcare.

The latest set of medical reform policies will also help alleviate the severe concentration of talent, educational and other infrastructure in the greater Seoul region in the long run. Most of the increased quota will be allocated to medical colleges outside Seoul, Incheon and Gyeonggi Province, and at least 60 percent of the students admitted to those schools are to be graduates of nearby high schools. The government will also provide med students and doctors who sign a contract to work in regions outside the greater Seoul area for a certain period of time with scholarships, training expenses and housing in addition to hiring them as professors.

Medical colleges outside the greater Seoul area are already required to have students who completed three years of high school in their respective regions account for at least 40 percent of their admission quota (20 percent for those in Gangwon and Jeju Provinces). At the medical colleges of Gyeongsang National University, Pusan National University and Chonnam National University, the ratio of local students is 80 percent. Starting from 2028, the “local students” are also required to have completed middle school outside the greater Seoul area and have resided in the regions their schools are located in.

Such rules were added as part of efforts to promote regional development. Graduates of high schools in the greater Seoul area accounted for 60.3 percent of medical school freshmen admitted through regular admissions in 2022. Those from Seoul’s Gangnam-gu, Seocho-gu and Songpa-gu took up 22.7 percent in the regular admissions, in which the state-administered college entrance exam is given a lot of weight, as opposed to early admissions.

Nevertheless, the Korea Medical Association, which consists of mostly doctors who own their practices, and the Korean Intern Resident Association, with a membership of some 15,000 interns and residents, have vowed to take collective action, likely a strike. Health Minister Cho Kyoo-hong on Wednesday discussed countermeasures with chiefs of 221 hospitals that train interns and residents through a video conference. The government has said it will take stern measures should the doctors’ groups engage in illegal acts “by taking the people’s health hostage.”

Under the Medical Service Act, the government can order medical personnel to resume medical services if they have halted them without a justifiable cause. Violators of the order can have their licenses suspended for up to a year, and face up to three years in prison or a fine of up to 30 million won.

While the doctors’ groups should continue to discuss with the government contentious issues such as restricting fresh graduates of med schools from starting their own practice, they no longer have convincing causes to justify another strike against the quota increase itself.

The number of practicing physicians in Korea per 1,000 people, excluding practitioners of Korean traditional medicine, stood at 2.1 in 2021, much lower than the OECD average of 3.7. Korea had 7.3 med school graduates per 100,000 people, about half of the OECD average of 14. But the average annual wage of salaried physicians in Korea amounted to $192,749 in 2020, among the highest in the OECD. The OECD average wage for doctors was about 60 percent of this.