The Korean government officially announced an expansion of medical school enrollment quotas by 2,000 for the academic year 2025, marking the first significant increase in 27 years, on Wednesday.

According to Deputy Prime Minister and Minister of Education Lee Ju-ho, during a press conference held at the Government Complex Seoul, the government has strategically allocated 82 percent of the new medical student seats to non-capital regions, with the remaining 18 percent designated for the Gyeonggi Province and Incheon.

Notably, the enrollment quotas for Seoul-based medical schools will remain the same.

The expansion plan is a result of applications received from universities between Feb. 22 and March 4, followed by thorough discussions by the Medical School Student Quota Allocation Committee, which includes experts in the field.

Out of the 2,000 quotas,  1,639 will be distributed among 27 universities outside the capital area, elevating their quotas to 72.4 percent of the national total, up from the current 66.2 percent.

The remaining 361 slots will be allocated to five universities in Gyeonggi Province and Incheon where medical schools had 50 or fewer quotas per school. 

There will be zero additional seat for eight universities located in Seoul.

When looking at each university, the allocated quotas in provincial areas for next year are as follows: Kangwon National University (132), Yonsei University branch campus (100), Hallym University (100), Catholic Kwandong University (100), Dongguk University branch campus (120), Kyungpook National University (200), Keimyung University (120), Yeungnam University (120), Daegu Catholic University (80), Gyeongsang National University (200), Pusan National University (200), Inje University (100), Kosin University (100), Dong-A University (100), University of Ulsan (120), Chonbuk National University (200), Wonkwang University (150), Chonnam National University (200), Chosun University (150), Jeju National University (100), Soon Chun Hyang University (150), Dankook University Cheonan (120), Chungbuk National University (200), Konkuk University branch campus (100), Chungnam National University (200), Konyang University (100), and Eulji University (100).

For Gyeonggi Province and Incheon, the allocations are as follows: Sungkyunkwan University (120), Ajou University (120), CHA University Medical School (80), Inha University (120), and Gachon University (130).

The government has based this quota allocation on three main criteria aimed at establishing a "regionally self-sufficient medical system" to ensure that all citizens have access to quality healthcare services.

These criteria focus on reducing the medical disparities between the capital and non-capital regions and addressing the differences in medical conditions within the capital region itself.

Despite the medical community's strong opposition to the policy, including mass resignations planned by professors, industry watchers believe that as the government made the official announcement, the admission quota increase plan is now irreversible.

The Ministry of Education has pledged to cooperate with relevant departments to support universities in improving medical education conditions, including faculty recruitment and facility expansion.

"This expansion of medical school quotas marks the beginning of healthcare reform and will serve as an opportunity to reduce the healthcare gap between the capital and non-capital regions,” Deputy Prime Minister and Education Minister Lee Ju-ho said. “The Ministry of Education will listen to the voices from the field as a partner to universities and work together to overcome the challenges posed by the quota increase."

Medical community at a crossroads

As the government confirmed the policy of increasing the medical school admission quota, despite the strong opposition from the medical community, including the collective resignation of medical residents, the medical community now faces a crossroads on whether to intensify their opposition or to accept the increase and engage in dialogue to ensure their voices are heard in the process of medical reform.

The number of medical residents who have left their positions currently reaches a staggering 93 percent of the total. According to the Korean Intern and Resident Association (KIRA), as of Monday, only 3.1 percent of residents across 98 hospitals are still working.

The situation is further compounded by plans for collective resignations announced by medical school professors. The National Emergency Committee for Medical School Professors reported that as of Monday, 16 out of the total 40 medical schools had decided on mass resignations, with more schools joining the movement.

Most professors have set their resignation deadline for next Monday, indicating that collective actions by the professors are expected to intensify from this date. While the professors have stated they will remain in the medical field until their resignations are accepted, the prolonged situation could potentially lead to a more severe impact on healthcare services.

Furthermore, the movement among medical students toward mass leave of absence is growing. According to the Ministry of Education, a survey conducted among the nation's 40 medical schools revealed that there were 512 "effective leave of absence" requests, which complied with procedures such as parental consent and department head signatures, across 11 schools on Tuesday. Over the last eight days alone, 2,926 students have submitted effective leave requests.

The Korean Medical Association (KMA), primarily comprising doctors running local clinics, is also likely to engage in collective actions such as mass clinic closures or reduced weekend and holiday services soon. 

What caused all this?

Meanwhile, the ongoing dispute between the government and the physician community stems from the government's announcement of plans to raise the national medical school admission quota sharply by 2,000 beginning next year on Feb. 6.

The government stressed that the increase in admission quota aims to address the chronic shortage of healthcare providers in rural areas and essential, albeit less lucrative, medical specialties. 

This shortage has been spotlighted by incidents such as pediatric open runs and incidents where patients could not find an opening for emergency rooms, underscoring the dire need for more medical personnel.

However, the medical community argues that the issue at hand is not the total number of doctors but rather the internal distribution of medical professionals across specialties. 

Recent years have seen a decline in residents applying for essential specialties such as internal medicine, surgery, obstetrics/gynecology, and pediatrics. 

At the same time, there's been a notable trend towards specialties that are either lucrative or have comparatively less demanding workloads, like dermatology, ophthalmology, and plastic surgery.

The medical sector contends that merely increasing the number of medical students will not resolve the skewed distribution of medical specialists, advocating for an improved payment system in essential medical fields to encourage more residents to choose these areas.

Amid other concerns raised by the medical community includes the possibility of the quality of medical education being lowered, the government has promised to maintain educational standards through measures like increasing the number of medical faculty positions and managing investments in private universities. 

Also, while the medical community warns of a potential rise in healthcare costs due to an increase in the number of doctors, the government counters by arguing that aging, rather than the number of physicians, is the primary driver of healthcare expenses.

The government suggests that the timely treatment and reduction in socioeconomic costs will offset any potential increase in healthcare spending.

Korea's current low birth rate and increase in aging population is another topic where the government and medical community present contrasting views. 

The government insists on expanding medical school quotas to meet the growing healthcare demands of an aging population, while the medical community fears that a decrease in population will lead to an oversupply of medical professionals, exacerbating the issue of resource distribution within the healthcare sector.