"If Patients Flock to Seoul, Public Healthcare and Public Medical Schools Are Useless"

At the Korean Academy of Medical Sciences Conference, Lee Administration's Regional Healthcare Policies Criticized
"Doctors Can Only Settle if There Are Enough Regional Patients"
"Budget for One Public Medical School Could Support Tuition for 25,000 Students"

The medical community has pointed out that the Lee Jaemyung administration's pledge to strengthen regional healthcare by establishing new public hospitals and public medical schools should first address the issue of patients flocking to Seoul, rather than simply expanding the quantity of medical services. There were also opinions that, given the financial and institutional limitations of establishing public medical schools, introducing a 'regional doctor track' may be a more practical solution.

At the '2025 Korean Medical Association Academic Conference' held on the 13th at Plenty Convention in Seocho-gu, Seoul, Changsoo Kim, Policy Director of the Korean Medical Association, is speaking. Photo by Jo Inkyung

Changsoo Kim, Policy Director of the Korean Medical Association, stated at the '2025 Korean Medical Association Academic Conference' held on the 13th at Seoul St. Mary's Hospital Plenty Convention, "It is disappointing that the current administration is still focused solely on quantitative expansion regarding securing medical personnel," adding, "Simply increasing medical school quotas or implementing a regional doctor system will not be enough to encourage patients to choose regional healthcare."

Kim further commented, "It is important not only to create conditions for doctors to settle in regional areas but also to manage their professional careers, but this aspect is missing, making the policy inevitably patchy," and asserted, "In particular, the persistent issues raised by the medical community, such as the avoidance of certain regions and specialties by medical professionals, are difficult to resolve with the current approach."

He also criticized the lack of measures to define and facilitate cooperation between private medical institutions and public hospitals. Kim said, "Currently, personnel expenses at regional public medical institutions exceed 60%, while private institutions of similar size have personnel cost compensation at only 20-30%," adding, "It is problematic to simply invest without policies or alternatives to overcome these structural limitations."

Sanghyuk Ma, Professor of Pediatrics at Changwon Fatima Hospital, emphasized, "There must be a sufficient number of patients in the region for doctors to settle there," and stressed, "We must first address the issue of regional patients flocking to the Seoul metropolitan area." He argued that to efficiently utilize regional medical resources, it is necessary to establish a system for information sharing among regional medical institutions and to build an efficient patient transfer system between institutions. Ma pointed out, "If local areas disappear, such policies are meaningless," and added, "There have been no policies to address this so far, and the current situation is a natural consequence."

Janghwan Bae, Professor of Cardiology at Good Samsun Hospital, also stated, "The government is announcing massive supply-side policies such as public hospitals and public medical schools, but the important issue is the demand side, with regional patients going only to Seoul," and lamented, "For regional doctors, what matters is having enough patients to settle in the area. If my patients go to Seoul, I will also have to go to Seoul."

Accordingly, there was an opinion that introducing a regional doctor track could be more practical for revitalizing regional healthcare than establishing public medical schools and hospitals. The regional doctor track refers to a system in which existing medical schools introduce a 'regional doctor selection track' and foster doctors who will perform essential and critical medical functions in the region through government funding. After obtaining a medical license, doctors are required to serve in a specific region or institution for ten years.

Yuil Kim, Policy Director of the Korean Academy of Medical Sciences (Professor of Pulmonology at Chonnam National University Hospital), citing data from the National Assembly Budget Office, argued, "Establishing one medical school requires a budget of about 200 billion won, which is enough to support 25,000 students with the average annual tuition of a national medical school, 8 million won," and added, "Due to financial and institutional limitations, establishing public medical schools is not a desirable solution for expanding public healthcare." He explained that while the regional doctor track can utilize the existing infrastructure of medical schools, establishing a public medical school would require enormous costs not only for educational infrastructure but also for training hospitals and other facilities.

Kim further stated, "Considering that regional medical centers are already burdened with massive deficits, the actual financial burden for medical schools and teaching hospitals will be much greater," and added, "From next year, the Medical Personnel Supply and Demand Estimation Committee will determine medical school quotas, which could also limit securing quotas for public medical schools." He concluded, "Given that the regional doctor track can be implemented immediately using existing medical schools, it may be a more practical solution," and emphasized, "It is also necessary to improve environmental factors in the region so that the mandatory service period is observed and essential regional healthcare is chosen."

Kang Jun, Director of Medical Reform Planning at the Ministry of Health and Welfare, who attended the academic conference, stated, "We will seek various systems to secure sufficient medical personnel," and added, "I believe that the National Public-Centered Medical Reform Deliberation Committee will be able to address issues such as increasing medical school quotas, the regional doctor system, and the expansion of the supply base, including public medical schools, based on scientific evidence and social consensus."