[Insight & Opinion] Medical Schools and Training Hospitals Are Collapsing Together

The Korea Council for University Education unanimously approved next year’s university admission system changes. It has been ‘confirmed’ that the medical school quota will increase by 1,509 students compared to last year. The government’s position is that once the final university-specific admission guidelines for next year are announced by the 31st, the nearly 100-day unilateral push by the government to expand medical school quotas will effectively come to an end.

However, the situation on the ground is completely different. The medical disruption that began in February does not seem likely to end easily. Residents and medical students, who have been driven out as ‘demons’ and have left hospitals and lecture halls, remain unmoved. Using the flimsy excuse of medical reform that will only show effects in 10 years to immediately dismantle today’s medical schools and healthcare system is a clear policy failure. The fierce backlash from the increase in medical school quotas has already begun. Of course, the full burden of this damage falls on the public.

The system for training specialists who must immediately handle essential and regional medical care is collapsing. This year, the number of new interns starting has dropped from 3,000 to 130. The number of residents who must complete training and take specialist qualification exams is also significantly decreasing. Securing military doctors and public health doctors is becoming difficult. This means that the once stable specialist training system has begun to collapse uncontrollably. Red lights have also turned on for essential medical care, known for hospital management and emergency room rotations.

The ‘mechanical law enforcement’ that the government emphasized whenever it spoke is not as easy as it sounds. Residents cannot be driven out as ‘demonic criminals’ simply because they submitted resignations at the end of their contracts and left hospitals. To revoke licenses, refuse resignation acceptance, and block domestic and international employment, legal procedures are required. It is unlikely that the judiciary will recognize the executive branch’s unilateral administrative measures that even disregard the constitutionally guaranteed freedom of occupational choice.

The situation in medical schools, where students have left lecture halls, is also desperate. Next year’s first-year medical school classrooms will become chaotic with the increased number of new students mixed with returning students who failed or are retaking courses. The confusion in medical school classrooms and labs will not end next year. The absurd competition that begins in medical school classrooms next year will become a lifelong burden for all medical students.

The 100 training hospitals, mostly operated as affiliates of medical schools, will also collapse. The Ministry of Health and Welfare’s plan to transform training hospitals into ‘specialist-centered’ institutions is as absurd as the medical school quota increase. The transformation of training hospitals is a reform task as difficult as increasing medical school quotas.

Reducing the proportion of residents in training hospitals is much more difficult than increasing medical school quotas. It is not resolved simply by hiring more qualified specialists. The number of training hospitals responsible for strict apprenticeship-style training for young doctors graduating from medical schools each year must also increase. Training hospitals require specialists to provide training and patients to offer training opportunities. Of course, enormous financial support is also necessary.

Procedural issues are also serious. Some universities have yet to complete amendments to their academic regulations reflecting the increase in medical school quotas. Some universities continue to face strong opposition from professors and students. Educational reforms centered on deregulation of universities have also lost their meaning.

The Ministry of Health and Welfare bears full responsibility for collapsing doctor training and the medical service system. The responsibility cannot be shifted to residents and medical students. True medical reform must start again by rectifying the incompetent Ministry of Health and Welfare.

Lee Deok-hwan, Professor Emeritus at Sogang University, Chemistry and Science Communication