Home > Opinion > Columns

Time for medical students to return to school

Published: 25 Mar. 2025, 00:03 Updated: 26 Mar. 2025, 17:31

이

Lee Tae-jin

The author is the dean of the Graduate School of Public Health at Seoul National University.

The standoff between the medical community and the government, sparked by the latter’s announcement in February last year that the medical school enrollment quota would increase by 2,000, has entered its second year. Recently, however, there have been signs that medical students who had refused to return to campus are now reconsidering.

This shift in attitude seems to be largely driven by the government’s more flexible approach. Authorities recently announced that for the 2026 academic year, the number of incoming students would remain at the 2024 level, without any increase. Starting in 2027, enrollment figures will be adjusted based on the findings of a newly established medical workforce forecasting committee, of which physicians make up the majority. Universities also made it clear that students who do not return risk being held back or expelled — a stance that likely influenced students' decisions.

To be sure, this plan to freeze enrollment has been criticized by patients, families and civic groups who endured inconvenience and uncertainty over the past year. Many see it as a retreat from long-overdue health care reform. But it can also be viewed as an exit strategy aimed at restoring medical education — the very foundation of the future health care system.

Medical staff walk inside a general hospital in Seoul on Feb. 19. [NEWS1]

Despite public hopes for an end to the standoff, many medical students remain hesitant to return. Why? There are likely multiple reasons, but the collective culture of the medical community and the influence of professional associations cannot be ignored. For example, both the newly elected president of the Korean Medical Association (KMA) and the interim head of the Korean Intern Resident Association — both backed by junior doctors — have publicly stated that there should be no new medical school admissions in 2026.

Given the hierarchical and tightly-knit nature of medical training and education, such declarations serve as powerful internal stances that pressure students to conform — whether they personally agree or not. Online communities that monitor and expose the names of returning students and trainees add to that pressure, making it even harder for individuals to break ranks.

From an economic standpoint, the theory of rational choice suggests that individuals weigh marginal costs against marginal benefits. What are the added costs of continuing the walkout at this point? The resignations of medical residents have led to a rise in the supply of general practitioners and a decrease in specialists, further widening the income gap between the two groups. For residents who left their posts, this gap translates into a significant opportunity cost — not only in lost income but also in lost time.

The same applies to medical students. The longer they postpone returning to school, the longer they delay starting their careers as physicians, increasing the personal cost of the protest. But what additional gains are left to be had? In truth, many of the medical community’s demands have already been met — from the 2026 enrollment freeze and the launch of the forecasting committee to active discussions on reducing legal liability for health care providers. Continuing the protest is unlikely to yield much more, especially considering how unpopular the idea of canceling the 2026 admissions cycle is with the general public.

When the protest began, residents and students said their decisions to resign or take leave were made freely and independently. A year later, in a changed landscape, their decision to return should likewise be based on reason and autonomy.

The entrance to Konyang University's medical school building [KIM SUNG-TAE]

Most of all, the leadership of the KMA and resident associations must lead by example. As one medical school dean aptly put it, student doctors — the “militia” — must not be used as cannon fodder in place of the “regular army,” the established physicians. While the KMA has recently adopted a more conciliatory stance, encouraging students to decide for themselves whether to return, it should go a step further and urge them more actively to resume their studies and leave the remaining fight to their seniors.

Medical students must be free to decide for themselves whether to return to school. In this regard, it is troubling that some universities continue to collectively refuse to return. Given the strength of group culture and peer influence, medical schools should consider holding democratic, schoolwide votes to allow students to express their individual intentions — much like they did during the doctors’ strike over the 2000 drug-pricing reform.

Recent news of some students returning has been as welcome as rain after a long drought. The yearlong protest was not without impact. But like the young Chinese disillusioned by burnout who chose to “lie flat” and disengage, medical students now face a choice: collective ruin, or a future built on coexistence — for the sake of patients, the public and their own careers. One can only hope they choose the latter.

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