1st official dialogue between presidential office and medical community shows only deep divisions

The first diaglogue on Thursday between the Presidential Office and the medical community over the issue of increasing medical school admissions ended without any fruitful results.

Persistent differences in their positions, along with internal criticism from within the medical community, underscored the need for more time to resolve the conflict.

The debate, held at Seoul National University, brought together key figures from both sides, including Jang Sang-yoon, senior presidential secretary for social affairs, and Kang Hee-gyung, chairperson of the emergency committee for the Seoul National University College of Medicine and Seoul National University Hospital faculty association.

However, criticism of the forum itself arose even before the start, with some voices from the medical community questioning the representativeness of Seoul National University College of Medicine.

Seemingly aware of the backlash within the medical community regarding their representativeness, Seoul National University College of Medicine distanced itself by acknowledging that they do not represent all doctors.

Government's argument for increased admissions

The Presidential Office maintained that increasing medical school admissions by 2,000 is the minimum requirement based on scientific studies predicting a shortage of doctors. Jang argued that these studies forecast a shortfall of 10,000 doctors by 2035 and that the actual need could be as high as 4,000 additional doctors when accounting for current working conditions.

Responding to criticisms of unilateral policy implementation, Jang defended the government’s efforts, urging the medical community to continue dialogue.

"The government has been officially promoting medical reform since January 2023,” Jang stated. “We established a consultative body with the Korean Medical Association and held 37 rounds of consultations on the issue of increasing admissions alone."

Despite these efforts, the forum was tense. When Jang mentioned the 37 consultations, voices from the audience accused him of lying, revealing the deep mistrust between the parties.

Jang further explained that just before the government's announcement to increase medical school admission by 2,000, they sought feedback from medical organizations. He noted, "Only the Korean Hospital Association responded, suggesting an increase of 3,000 students." He expressed regret over the ongoing collective action by residents and medical students, which has continued for eight months.

Jang emphasized that the shortage of doctors is supported by substantial scientific evidence and argued that an increase in admissions would not harm doctors’ socioeconomic status but may improve it, considering the growing healthcare needs of an aging society.

Jeong Kyung-sil, head of the medical reform promotion team at the Ministry of Health and Welfare, also countered the medical community’s demand to revisit the issue in 2025. She stressed the urgency of acting now, viewing the next decade as crucial for addressing the challenges posed by an aging society and the retirement of baby boomer doctors.

"The next 10 years are the last opportunity to respond to the crisis in essential and regional medical care and to prepare for a super-aged society," Jeong explained.

Medical community's objections

In contrast, the medical community expressed deep reservations about the government's approach. Professor Kang Hee-gyung questioned the necessity of increasing the number of doctors, pointing out that Korea’s life expectancy exceeds the OECD average by three years.

She argued that factors such as excessive medical use, the country’s low birth rate, and the aging population must be considered before labeling the current number of doctors insufficient.

“We can’t simply say there’s a shortage of doctors,” Kang stated, emphasizing the need to refine the medical system first by strengthening primary care and supporting essential medical services. “Doctors should be placed where they are needed most,” she said.

Kang also raised concerns about healthcare costs, projecting that by 2030, Korea will need to spend 16 percent of its GDP on healthcare, and by 2035, the figure could reach 20 percent.

She suggested that by improving the efficiency of the current system, these costs could be contained, underscoring the importance of directing doctors to underserved areas.

Professor Ha Eun-jin, a member of the emergency committee for Seoul National University Medical School, criticized the government's aggressive measures, warning of potential negative consequences before any benefits are realized.

"Hasty agreements will only lead to another crisis within a few years," Ha warned. She emphasized that meaningful discussions must continue until sustainable healthcare reforms are achieved, calling for patient-centered, financially stable reforms.

Ha urged the government to halt its plan to increase medical school admissions and re-engage in dialogue with the medical community.

She further noted that the reason many residents left the field was that they saw no future in Korean healthcare.

“These residents are not people without a sense of responsibility," Ha said. "They need to return and care for patients, but isolating them, labeling them as wrong, and just continuing to fight won’t solve the problem."
 

Trust issues and procedural concerns

The medical community also highlighted a lack of trust in the government's decision-making process. The issue of trust extended to ongoing protests by resident doctors and medical students.

Jang described these protests as "collective action by residents and medical students," attributing them to anxiety over their future careers. However, Professor Kang questioned whether these protests could be considered collective action, pointing to a 2020 agreement between the Korean Medical Association and the Ministry of Health and Welfare, which promised no unilateral decisions regarding medical school quotas.

“The perceived breach of this agreement has fueled skepticism among younger doctors,” Kang added.

Ha agreed. 

"Concessions need to be made, but there is a lack of trust," Ha said. "Please, make us believe in the government again."

Jang's statement on medical school student leave faces severe criticism

Jang's comments on the issue of medical students taking leaves of absence during the forum faced severe criticism from the audience.

Jang had stated that a leave of absence is not a right, and that medical students are not filing for a proper leave of absence.

His remarks directly confronted the position of the joint emergency committee of the Korean Association of Medical Colleges, which had previously criticized the Ministry of Education's conditional approval for leaves of absence, stating, "Granting leave based on the assumption of returning in 2025 is a violation of students' rights and is coercion and intimidation."

"Students who have taken a leave of absence claim that it is a right, but a leave of absence is not a right," he said. "It is granted when a student enrolled in the curriculum faces unavoidable or unforeseen circumstances. "

Jang stressed that the fact that all students, in protest of government policy, are filing for leaves of absence en masse, rendering them unable to attend classes, cannot be considered a personal reason. 

In response to Jang's comments, there were protests and shouts from the audience stressing that he does not make the rules.