Korea’s medical system needs an overhaul

The government and medical representatives have held a council to start discussions on increasing the medical school quota. The government wants to increase the enrollment quota, but the Korea Medical Association (KMA) steadfastly resists. In the meantime, patients are dying as they cannot find emergency beds and doctors.

Pediatric departments are swarmed with patients because they are short. Hospitals outside the capital cannot find doctors even if they offer up to 1 billion won ($766,871) in salary. Despite the dire deficiencies in primary care, Korea claims its medical care is the world’s best in treatment standards and access.

For the last 18 years, the annual admission quota at medical schools was frozen to 3,058. The government’s negligence in promoting essential fields of medicine and the fast-aging population, as well as young doctors’ shunning of risky and hard fields, also have worsened the problem.

More doctors at hospitals and those who can make house calls are needed. The Korea Institute for Health and Social Affairs estimates that nearly 30,000 doctors would be short by 2035. Japan has raised the medical school quota by 1,705 to 9,330 to turn the tide. The United States has bumped up the quota by 38 percent over the last 20 years while Britain is doubling the number and Germany upping its by 50 percent. The government hopes to increase the quota starting 2025. The KMA proposed hiring retired doctors to help address a lack of doctors because even if the number of medical students increases, it doesn’t mean they would apply for the essential fields and rural areas short of doctors. The problem can be solved by increasing the medical school quota while offering incentives for the essential fields and rural areas at the same time. Medical schools in areas outside the capital also should be able to offer more openings and applicants for jobs in rural areas should be given financial and housing benefits.

While the enrollment quota needs to be increased, authorities should be more prudent in creating a new public medical school. It would not be realistically easy for the new public school to recruit excellent professors and secure hospitals where trainees can gain experience. Some argue the annual quota should be increased by 351 as in the past. But an increase by some hundreds won’t solve the problem.

An independent body comprising the KMA, doctors, local governments and other experts can discuss the supply of doctors by benchmarking Japan’s case. Also, national universities in Busan and South Jeolla should be allowed to take responsibility for medical services in the surrounding areas. The basic framework of the Korean medical system needs a complete makeover.