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A Health Workforce Projection Committee for the people

Published: 20 Feb. 2025, 00:02

Shin Hyun-ho

The author is a managing attorney at Law Office Haeul.

Judicial system reforms, which began with the Civilian Government (1993-1998), gained momentum during the Roh Moo-hyun administration (2003-2008). The Judicial Reform Promotion Committee, composed of 21 members representing various sectors — including the legal and academic communities, the executive branch, media, business, labor unions, civic groups and women’s organizations — sought to expand the training of legal professionals through law schools, introducing citizen participation in criminal trials, implementing pretrial detention hearings, ensuring the independence and neutrality of military courts, separating prosecutorial and police investigative powers and unifying the legal profession. President Roh confronted vested interests head-on, holding sessions like the Conversation with Prosecutors, while systematically incorporating judicial frameworks that had taken centuries of civic sacrifice to establish in advanced democracies.

The once-exclusive legal profession, with its mere 3,000 lawyers selected at an annual rate of 300, became widely accessible as law school admissions expanded, surpassing 30,000 licensed attorneys. Lawyers, who were once found only in courtrooms, now work in government offices, public institutions, financial firms, corporations, media outlets and hospitals, making legal services more accessible to the public. Recently, during the Dec. 3 emergency martial law incident, when the Counterintelligence Command attempted to seize the National Election Commission’s servers under the pretext of investigating electoral fraud, military legal officers intervened, calling it unlawful. Similarly, when the Special Warfare Command prepared to use weapons, the military’s chief legal officer advised that orders must come from the martial law commander, preventing a potential repeat of the Gwangju Democratization Movement massacre near the National Assembly.

Medical professors, junior doctors, medical students and private practitioners participate in an outdoor rally in Yeouido, western Seoul on June 18, 2024, demanding the government to amend its medical policy packages. Over 12,000 health care professionals joined the protest, according to the police. [YONHAP]

On Jan. 9, the Ministry of Defense Military Court acquitted the Marine Corps Investigations Chief of insubordination charges. This ruling was possible because the Judicial Reform Promotion Committee had restructured the Military Criminal Act to guarantee the independence of military courts and military legal officers — an outcome unimaginable in the past when military tribunals operated under the direct command of generals and division commanders. By excluding vested interests and involving citizens in judicial reform, Korea successfully prevented a regression to authoritarian rule in 2025. On a smaller scale, these reforms protected both the lives of citizens guarding the National Assembly and the personal rights of the Marine Corps investigator.

Meanwhile, the government’s plan to increase medical school admissions has sparked backlash, with resident doctors resigning en masse and medical students delaying their return to school. Some media outlets warn of a health care crisis or even a collapse of the medical system. However, a shortage of physicians — particularly in public hospitals — triggers a real health care crisis, and delaying medical education could make such a collapse a reality. Ironically, now is precisely the right time to increase the supply of doctors. The mass resignation of residents has had an unintended positive effect by redistributing patients from university hospitals to primary and secondary health care facilities, restoring balance to the health care delivery system. Professors at university hospitals, who were once burdened with treating dozens of patients daily while holding adjunct physician positions, can now focus on medical research and provide higher-quality education to medical students.

Doctors wearing their medical gowns walk inside a general hospital in downtown Seoul on Aug. 29, 2024. [YONHAP]

Nevertheless, some argue that expanding medical school admissions will compromise the quality of medical education and health care, lead to a concentration of elite students in medical schools at the expense of engineering disciplines and grant current medical students and residents leverage in negotiations. On Feb. 14, the National Assembly Health and Welfare Committee proposed amendments to the Framework Act on Health and Medical Services and the Medical Services Act to establish a Health and Medical Workforce Projection Committee that would determine admissions quotas based on projected demand. A public hearing was also held. The proposed legislation, however, primarily calls for a committee composed of medical professionals, raising concerns about structural conflicts of interest and contradicting the rationale behind the prevention of conflict of interest law.

Medicine is one of the world’s oldest professions, predating recorded history. Just as it would be absurd to impose a fixed annual cap on driver's licenses, setting a rigid quota for medical personnel lacks objective justification. In the past, judicial exam quotas were regulated because the Prosecutors' Office Act required that government hiring be limited to a specific number of state employees. However, medical school admissions quotas should be legislated only for public medical schools, such as provincial medical universities, the Armed Forces Medical Academy and the Occupational Disease Medical School, to enhance the public nature of health care.

Meanwhile, private medical schools should be allowed to set their quotas independently. If projections must be made, they should account for nonclinical medical professionals working in research institutions, pharmaceutical companies, law firms and journalism, rather than focusing solely on clinical practitioners. To ensure medical and academic advancement, medical school admissions should be determined by the Education Minister, while the number of medical residency slots should be decided by the Health Minister — a dual-structured system that separates medical education from clinical training.

The Health and Medical Workforce Projection Committee must be designed as a system by the people, for the people and of the people. To achieve this, medical professionals — who have vested interests in the matter — should either be excluded from voting or limited to no more than one-third of the committee’s membership. Any amendments to the Framework Act on Health and Medical Services that contradict the principle of national sovereignty will ultimately be rejected by the public.

Translated using generative AI and edited by Korea JoongAng Daily staff.