Government: "Increase Medical School Quotas to Strengthen Regional and Essential Medical Care" vs Medical Community: "System Improvement First" (Comprehensive)

Differences in Views Over Expansion Scale... Loud Exchanges Among Audience Members

Professor Ha Eun-jin, a member of the Seoul National University Medical School Emergency Committee, is speaking at the discussion forum "Medical Reform, Where Is It Going?" held on the 10th at the Convergence Hall of Seoul National University College of Medicine in Jongno-gu, Seoul. Photo by Kang Jin-hyung aymsdream@

On the 10th, the government and the medical community, who have been at odds over the 'increase in medical school admissions,' held their first debate on medical reform. The government emphasized the position that "increasing medical school admissions is inevitable to revive regional and essential medical care, which is the purpose of medical reform," while the medical community countered that "strengthening compensation for primary and essential medical care" should be prioritized and that increasing medical school admissions cannot be a solution.

In particular, the government maintained the stance that an increase in medical school admissions is necessary due to the rapid aging population and medical demand, while the medical community pointed out that system improvements are more urgent than increasing medical school admissions to prevent the chronic problem known as the 'emergency room rotation' crisis.

Jang Sang-yoon, Senior Secretary for Social Affairs at the Presidential Office, attended the medical reform policy debate held at Seoul National University College of Medicine that afternoon and said regarding the controversial increase of 2,000 medical students, "This number was presented based on sufficient scientific evidence," adding, "Originally, an increase of at least 4,000 is necessary." He explained that South Korea can very precisely predict the supply and demand of doctors based on fundamental data such as future population projections, objectively indicating a shortage of doctors.

Yongsan: "At least 4,000 additional admissions needed according to projections"

Senior Secretary Jang emphasized, "Since the entire population is enrolled in health insurance, individual medical demand is measured very accurately, and the state directly manages the licensing and activities of doctors," adding, "Compared to any other field, projections can be made with minimal error."

He continued, "Even in the three expert studies referenced by the government, despite slight differences in assumptions, all showed a shortage of about 10,000 doctors by 2035," and said, "The government did not accept these three studies as they were but examined them more deeply, and after adjusting some unrealistic assumptions to fit reality, the shortage of doctors more than doubled."

Senior Secretary Jang stated, "In other words, the conclusion is that not 2,000 but at least 4,000 or more additional admissions are necessary," and added, "That is why the government has consistently said that 2,000 is the minimum necessary number."

He also said, "Beyond scientific evidence, just observing the medical field a little more reveals many bleak factors that will inevitably lead to a shortage of specialists responsible for essential medical care," citing "the rapid aging of doctors, with the growth rate of active doctors under 70 years old nearly zero after 2029, excessive specialization narrowing the scope per specialist, and accelerated outflow of personnel to non-essential fields."

Regarding criticism about insufficient consultation with the medical community, he said, "We held 37 separate consultations on the increase issue with statutory medical organizations such as the Medical Association," adding, "Just before the announcement, we also sent official letters to various medical organizations asking about the appropriate scale of increase, but no one responded. Only the General Hospital Association replied that an increase of 3,000 was appropriate."

On the 10th, government officials and members of the Emergency Committee of Seoul National University College of Medicine and Seoul National University Hospital professors attending the discussion titled "Medical Reform, Where Is It Heading?" held at the Convergence Hall of Seoul National University College of Medicine in Jongno-gu, Seoul, exchanged opinions. From the left: Jeong Gyeong-sil, Head of the Medical Reform Promotion Team at the Ministry of Health and Welfare; Jang Sang-yoon, Senior Secretary for Social Affairs at the Presidential Secretariat; Yu Mi-hwa, Executive Director of the Green Consumer Network; Kang Hee-kyung, Chairperson of the Emergency Committee of Seoul National University College of Medicine; Ha Eun-jin, member of the Emergency Committee of Seoul National University College of Medicine. Photo by Kang Jin-hyung aymsdream@

On the other hand, Kang Hee-kyung, Emergency Response Committee member of the Seoul National University College of Medicine and Hospital Professors' Association, compared how much domestic medical expenses have increased relative to each country's gross domestic product (GDP) and expressed concern that if this trend continues, the medical expenses burden on South Korean citizens will significantly increase. She argued that having more doctors could lead to higher medical expenditures.

Kang said, "Compared to the OECD average, South Koreans visit hospitals three times more and undergo many more tests," adding, "If unnecessary hospital visits are reduced, even three-minute consultations would disappear."

Medical Community: "Strengthen Primary Care and Build a Sustainable System"

Regarding the phenomenon of pediatric 'open runs,' Kang pointed out, "In the case of neurosurgeons, an important specialty behind the emergency room rotation problem, South Korea has many more doctors compared to other countries," adding, "Many specialists are currently not practicing in their fields, but if they return, issues like emergency room rotation and pediatric open runs will not be significant."

Kang also said, "Japan, which entered an aging society before us, has a similar number of doctors but is increasing slowly," adding, "Doctors worry that increasing their numbers will raise costs." She continued, "I want to propose enabling doctors to go where they are needed," and urged, "Strengthen primary care with expert teams who know me and my illness well, create a patient-centered medical system, and improve litigation conditions to build a sustainable medical system."

This debate was arranged after the Emergency Response Committee of Seoul National University College of Medicine and Hospital proposed it to the Presidential Office. From the government side, Senior Secretary Jang and Jung Kyung-sil, head of the Medical Reform Promotion Team at the Ministry of Health and Welfare, attended as discussants, while from the committee side, Professors Kang Hee-kyung and Ha Eun-jin of Seoul National University College of Medicine participated.

Before the government officials' opening remarks, there were shouts from the audience. One medical school professor shouted, "Have you simulated how many students will be in each department if the number increases by 2,000?" When Senior Secretary Jang said, "The medical community did not provide an answer regarding the appropriate increase," the professor also shouted, "That's a lie." After a brief pause, Senior Secretary Jang said, "Please allow me time to present," and continued speaking.