[Editorial] Quota for medical schools

The South Korean government is set to unveil a plan to increase the annual enrollment quota for medical schools in a bid to tackle the shortage of doctors in key fields and the increasing demand for medical services in connection with the rapid aging of Korean society.

Senior officials from the ruling People Power Party, the government and the presidential office held a meeting Sunday to explore options over the increase of the number of medical students.

President Yoon Suk Yeol is scheduled to announce the plan to boost the quota on Thursday, reflecting the importance of the change that will reshape the medical sector as well as the quality of health services available for people.

The government is reportedly considering increasing the enrollment quota by 1,000, which will be applied to medical schools from 2025. The quota has been fixed at 3,058 since 2006 amid prolonged disputes over the need to expand the number of medical school students.

An increase of 1,000 in the quota is larger than expected, as rumors earlier swirled that the government would increase the quota by 351 -- the number of students slashed in 2000 -- or push for an increase of 500. The higher-than-expected enrollment increase seems to be based on the earlier projection that Korea will confront a severe shortage of doctors in the comping years as well as the 10-plus years needed to educate and train them.

Compared with other countries, Korea has built up a solid public health insurance system that offers affordable and quality health services across the nation. But the country has long faced the chronic shortage of doctors, especially in unpopular medical fields that require burdensome workloads along with inadequate financial compensation.

It is well known that some patients in dire conditions often keep wandering in search of emergency rooms at hospitals, only to be repeatedly rejected due to the absence of qualified medical staff. The situation in hospitals outside the metropolitan area is even worse.

The imbalance between big cities and rural areas and between popular and unpopular medical fields cannot be easily resolved because of a host of policy factors and the conflicting interests of parties involved. But the consensus is that there are not enough doctors, as the quota has been unchanged in the past 17 years.

Korea has a ratio of 2.5 doctors per 1,000 people according to 2022 data. This is far behind the Organization for Economic Cooperation and Development average of 3.7 doctors per 1,000 people.

In 2025, Korea is expected to become a hyper-aged society, where those over 65 years old constitute 20 percent of the total population. One estimate suggests that the country could face a shortage of over 27,000 doctors by 2035 if the current trend continues.

Even if the government successfully pulls off its plan to increase the enrollment quota by 1,000 for medical schools, the ratio of doctors per 1,000 people is expected to rise to 3, a figure that still needs to be expanded to catch up with the level of other OECD member countries. Government officials, therefore, have to discuss whether additional quota increases will be needed down the road.

A tricky issue facing the government is uncertainties surrounding the impact of the quota increase in supplying much-needed doctors to unpopular fields such as pediatrics; obstetrics and gynecology; and thoracic surgery.

The Korea Medical Association, the largest medical doctors’ group in the nation, has been fiercely opposed to any quota increases, claiming the shortage of doctors has to do with the problems with the current health insurance coverage system.

In addition to this opposition from doctors, the government also has to consider the possibility that more students will be drawn to medical schools as a result of the increased quota and away from other fields that require skilled workers.

Given the complexity of the quota-related issues, the government must draw up more long-term policies to deal with the imbalance of health services and seek compromise with the medical sector.