[Insight & Opinion] Fifteen Large Hospitals on the Scale of Seoul National University Hospital Are Needed

Adjusting Next Year's Medical School Admissions Is Essential
Drastic Measures Needed to Resolve the Medical Vacuum

Forty-nine senior professors, concerned about the oppressive "medical reform" that the government has been aggressively pushing for seven months, have issued a heartfelt declaration on the current situation. They point out that the government's reckless medical reform, which is lost and confused, is driving the medical system toward mutual destruction. They urge an immediate halt to the attempt to increase medical school admissions and call for reasonable measures for the future. This demand aligns with the wishes of young medical students and residents. The trap set by bureaucrats who deceived the president and the public must be boldly broken.

The chaos in emergency, specialized, and regional medical care cannot be resolved simply by increasing medical school admissions. Adding 10,000 doctors ten years from now means nothing to medical sites that urgently need a bucket of clean water right now. Rather, correcting the medical administration that has failed to adapt to rapid social changes is far more urgent. Naturally, the true goal of medical reform must be to establish a medical administration framework that reflects the expertise of the medical community.

A 65% increase in medical school admissions is an outrageous act unseen anywhere else in the world. When the quota increases significantly, the quality of medical education inevitably declines. Moreover, considering that the government's proposed increase is temporary for five years, active government investment is impossible.

To make matters worse, doctor training does not end at medical school. Even after obtaining a "medical license," one must undergo a "training process" of more than four years to become a "specialist" who can independently treat patients. The "residents" who have left hospitals this time are precisely such trainees. Currently, about 3,200 interns are selected annually at 211 training hospitals, which is more than the medical school quota. Among them, 2,300 (72%) are selected at 47 tertiary general hospitals (university-affiliated hospitals). The "Big 5" large hospitals handle only about 100 residents.

Ultimately, to increase the medical school quota by as many as 1,509 students, 15 additional ultra-large tertiary general hospitals the size of Seoul National University Hospital would be needed. Equipping buildings and facilities is already a huge challenge, but securing medical personnel and patients is nearly impossible. To make matters worse, after five years, these additions will become useless burdens.

The current medical vacuum is not due to doctors' strikes but because residents, despairing over the government's reckless increase in medical school admissions, have given up on becoming doctors. The Education Ministry and Ministry of Health and Welfare ministers' naive "maximum persuasion efforts" have also proven futile. Medical students still refuse to return. The course registration rate for pre-medical students is only 7%, and the situation in the main medical courses is even more serious. There are quite a few medical schools with no tuition-paying students at all.

Regardless of the Education Ministry's administrative decision on whether to recognize academic probation, next March's medical schools will be overcrowded with 7,500 enrolled and new students. Normal education cannot even be expected. Entering medical school next year could be as dangerous as jumping into a fire carrying firewood.

The medical reform that demonizes medical students, residents, and specialists to push through unrealistic increases in medical school admissions must stop immediately. It must not be forgotten that replacing residents with PA nurses makes specialist training impossible. The "medical license system" to restrict residents is also nonsensical.

Drastic measures are needed to resolve the medical vacuum threatening public health. Adjusting next year's medical school quota is essential. There is an urgent need for justification that allows residents who have left hospitals to return. Moreover, in emergency rooms abandoned by residents, neither military doctors without emergency medicine training nor presidential secretaries can do anything.

Deokhwan Lee, Professor Emeritus at Sogang University, Chemistry and Science Communication