[Editorial] Quota dispute intensifies

The Yoon Suk Yeol administration’s plan to increase the annual enrollment quota for medical schools to deal with a chronic shortage of doctors is a hot-button issue, particularly for doctors who fiercely oppose such a change.

In the battle over the quota that involves a host of stakeholders and vested interests, the government has secured an important ally: universities calling for an increase in the quota for their medical schools.

Even with the help of universities in favor of a quota hike, however, the government faces a tough path ahead, as doctors have ratcheted up their protests.

The new development came Tuesday when the Ministry of Health and Welfare announced the results of a recent two-week survey conducted at 40 medical schools nationwide. The ministry said that the universities want the medical school quota to increase by some 4,000 by 2030.

For the 2025 academic year, universities said the quota should be raised by between 2,151 and 2,847. Universities also hold the view that the number of additional medical school students should be in the range between 2,738 and 3,954 by 2030, according to survey results.

Given that the government considered an increase of 1,000 for next year's college exam, the figures suggested by universities topped expectations. The gap seems to shed light on pent-up demand for medical school students due to quota restrictions at universities as well as ever-stronger competition among students to become doctors, attracted by better security, higher social status, more opportunities for advancement and far greater pay than other professions.

The quota has been fixed at 3,058 since 2006, amid a severe shortage of doctors in essential yet unpopular medical fields and an outlook for surging demand for medical services in line with the rapid aging of Korean society. But previous attempts to change the quota all failed due to vigorous opposition from doctors.

Despite -- or because of -- the fixed quota and a severe shortage of physicians, the popularity of the profession is surging. One reason is better pay.

According to the 2023 OECD Health Statistics report, Korean doctors outearn their counterparts in 27 other member countries that submitted relevant data. The annual earnings of salaried medical specialists in Korea averaged $192,749 in 2020, adjusted for purchasing power parity.

The same report also shows that Korea has a ratio of 2.6 doctors per 1,000 people, which is far behind the Organization for Economic Cooperation and Development average of 3.7 doctors per 1,000 people.

It is no surprise that existing doctors do not want to see their field crowded with more potential rivals, which could result in less income and higher competition, as demonstrated by what happened in the legal sector after the government overhauled the state exam system in a way that dramatically expanded the number of newly licensed lawyers.

As expected, the Korea Medical Association, the largest medical doctors’ group in the nation, held a press conference Tuesday and claimed that the survey was unfairly conducted to steer public opinion toward the government’s quota increase plan.

The KMA said it could go on a general strike in protest if the government unilaterally pushes for the increase of the medical student quota without enough scientific evidence and communication.

On Wednesday, the Health Ministry and the KMA held a regular meeting to discuss the medical agenda, which inevitably addressed the controversial survey results. The two sides exchanged their contrasting views over the issue and prematurely ended the meeting in just about 10 minutes.

Of course, there are various factors other than the quota that threaten to jeopardize the country’s health care system, such as distorted insurance coverage. But experts warn that even an extra 4,000 medical students by 2030 may not be enough, citing projections that an additional 20,000 doctors will be needed in the next 10 years.

Considering the make-or-break shortage, the government should stick to its plan while drawing up a realistic quota increase in close consultation with the KMA and other stakeholders.