Increasing the quota is just the beginning

The government has taken on the challenging mission of alleviating the deficiencies in primary-care and rural medical infrastructure through addition of 2,000 in medical school enrollment from next year. Increasing doctors’ number could be the starting point of sustaining the medical ecosystem in an aging society. But that does not solve all of the problem. The action must be accompanied by a meticulous roadmap — and persistent monitoring — to make sure the increased doctors can cover the dire shortages in primary-care divisions and rural areas.

The government unveiled a policy package to supplement the primary-care medical field. It will inject more than 10 trillion won ($7.5 billion) through 2028 to rationalize the national insurance payout rates to medical facilities. The benefit would mostly go to the primary-care departments, with rates differentiated depending on the complexities and urgency of the treatment and overtime of doctors. Departments of critical-care emergency, pediatrics, and maternity care are specified, but the plan requires fine-tuning on how much and where the funding should go.

As important as assistance to medical fields deficient of doctors is to mitigate the bias towards popular fields. The government originally introduced a plan to ease the provision requiring licensed doctors perform certain cosmetic services so as to allow nurses to carry out simple injections of botox and derma fillers. But the plan was immediately withdrawn in the face of strong protest from doctors. If the government backtracks at every opposition from doctors, the doctoral imbalance cannot be corrected. The government must mandate transparent disclosure of non-coverage service and cap the limit so that the burden on patients do not shoot up.

Beefing up medical infrastructure in local areas is a more challenging task. The government proposes to up the quota for local students in local medical schools to 60 percent and mandate medical services in the region for certain period on a contract basis. But due to lack of penalties on breaking the contract, whether doctors will choose to stay on purely on some incentives is uncertain.

Where the increased quota for medical students will go to should be decided first. The extra openings are likely to be reserved for local public universities responsible for primary medical services in provincial areas and small medical schools with current quota of fewer than 50. But whether these facilities can be fully capable of training reliable doctors is also questionable.

The sudden spike in medical school quota can further steal away talents in STEM branch. The immediate rush may be inevitable. But the government must set direction in providing incentives for engineering and basic science to diversify the talent pool in STEM field in a balanced manner.