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Concerns grow over Education Ministry’s medical curriculum reform plan

Published: 17 Jun. 2025, 00:04

Kwon Bok-kyu 

The author is a professor of Department of Medical Education at the Ewha Womans University School of Medicine

The core aim of medical education is to train physicians capable of treating patients. No matter how much empathy, leadership, communication skill or medical knowledge a student may possess, they cannot be considered fully trained without the ability to provide actual care. And that ability can only be gained through real clinical experience.

Personnel enter a medical school in Seoul on April 8. [YONHAP]

Whether through clinical performance examinations using standardized patients or simulations with artificial intelligence, these tools are merely preparatory steps. They are no substitute for actual patient care. Just as no pilot can safely fly a plane based solely on simulation training, no medical student can become a physician without direct patient interaction.

The fundamental problem with medical education in Korea is not outdated curriculums, substandard facilities or limited educational materials. Nor is it the overburdened faculty’s lack of engagement with teaching — although these are genuine challenges that can be overcome with investment and effort. The most serious issues lie elsewhere: a shortage of faculty, the limited time they can devote to instruction and, most critically, the lack of patients willing to be seen by students.

In advanced countries like the United States, clinical education is built around student-patient interactions. Students first study patients’ medical records. When patients visit the clinic or hospital, the student is the first to examine them — taking histories, performing physical exams and even ordering tests. Faculty then review the student’s findings, offer feedback and personally reexamine the patient to fill in gaps and correct mistakes.

This process is essential. Without it, students cannot learn how to treat patients. Basic procedures, like taking blood pressure or drawing blood, can be learned quickly. But being a doctor means extracting meaningful information from patients, reasoning clinically and making informed decisions. For this kind of training, adequate faculty numbers and patients willing to participate are indispensable.

Unfortunately, Korea’s medical education environment lacks both. In a system modeled after advanced nations, a professor might see only 10 patients a day to make room for proper instruction. Yet such an approach would cripple the financial sustainability of university hospitals under Korea’s current health care system. Hiring more faculty for teaching would worsen hospitals’ financial strain. Moreover, concerns about medical malpractice and legal liability make it nearly impossible to allow students to directly engage with patients. Patients themselves, aware of their rights, may resist being examined by trainees.

Despite these constraints, the Ministry of Education recently unveiled its Basic Plan for Supporting Medical School Education Innovation backed by 54 billion won (approximately $39 million). From the perspective of medical educators, the plan appears misguided.

Changing the medical school admissions process, developing student mental health guides and digitizing education might sound modern, but these do not address the core deficiencies in clinical education. Proposals like a vaguely defined “citizen-centered curriculum,” community-based instruction, portfolios or a new digital test bank to replace old exam collections are all peripheral. They cannot drive meaningful reform if the foundation of hands-on clinical learning remains weak.

If the Ministry truly aims to improve medical education, it must first ensure that university hospitals can survive even if each professor sees fewer patients to accommodate student instruction. More important, the government must foster an environment where patients trust the medical system enough to allow students to participate in their care — for the benefit of future generations.

Two doctors work in a compound of a general hospital in Seoul on November 11, 2024. [NEWS1]

Currently, medical education in Korea remains destabilized following the contentious proposal by the previous administration to increase the medical school admission quota by 2,000 students. That policy was introduced abruptly and triggered a protracted standoff between the government and the medical community. Even under a new administration, the wounds from that episode have yet to heal. In this context, the Ministry’s education reform agenda appears disconnected from reality.

The Ministry also failed to consult widely with the medical education community during the design of this initiative. No public debate took place. Given the timing, many suspect the plan was rushed during the height of the medical quota controversy. There are real concerns that this initiative may go the way of the now-defunct graduate medical school system — a failed experiment that wasted valuable public funds.

For any reform to succeed, it must begin by addressing the structural and clinical realities of Korea’s medical education. Without securing patient trust and restructuring hospital operations to prioritize teaching, no innovation — no matter how well-funded — can be effective.

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