The increase in medical school enrollment, along with medical reform, is a key policy pushed by the Yoon Suk Yeol government. The Yoon administration pointed to opinion poll results showing that over 70% of the public supports increasing medical school quotas, announcing plans to increase the number of medical students by 10,000 over the next five years at a rate of 2,000 per year. The government also stated it would address the shortage of essential medical personnel directly related to patient care and the regional disparity in healthcare.
However, due to President Yoon's emergency measures, the medical reform policies, including the increase in medical school enrollment, have been put at risk. The package of reform policies for essential and regional healthcare has also lost momentum. The financial difficulties and personnel shortages faced by major university hospitals, which play a crucial role in regional essential medical care, have deepened. There are criticisms that no issues have been resolved in the past year, only exacerbating political and social conflicts and divisions.
◇ Large-scale shortfall of residents at Big 5 hospitals next year… worsening personnel gap
According to the Ministry of Health and Welfare and medical community sources on the 11th, the application rate for first-year residents at 114 training hospitals nationwide, including the Big 5 hospitals (Seoul National University, Asan Medical Center, Severance Hospital, Seoul St. Mary’s Hospital, Samsung Medical Center), is only 8.7% (314 applicants) for the first half of next year.
If this continues, the personnel gap in major hospitals nationwide next year is bound to widen. Typically, hospitals across the nation select about 2,700 first-year residents out of a total quota of around 3,300 each year, but there has been a significant shortfall. According to the ministry, the application rates for first-year residents were 79.7% in 2022, 82.1% in 2023, and 83.2% in 2024.
In February, residents who opposed the increase in medical school enrollment collectively left the hospitals, creating a healthcare gap. As of the end of August, the number of resigning residents was 11,732. It is not just residents who are leaving; fellows have also been resigning in large numbers. A fellow is a physician who has completed their specialization and studies a sub-specialty while practicing in a training hospital for 1-2 years. The remaining medical staff, including professors nearing retirement, have been covering shifts to fill this gap for nearly a year. These medical staff are experiencing work overload and extreme fatigue (burnout).
The impact of this healthcare gap ultimately falls back on patients. The issue of emergency patients wandering around looking for emergency rooms continues to be highlighted. The shortfall of residents indicates a serious red flag for the training of medical professionals who will be responsible for future healthcare. A professor at a university hospital, who requested anonymity, noted, “If this continues, future patients will find it difficult to meet good doctors and professors.”
As the number of medical students entering active service increases, a shortage of public health physicians (public health officers) and military doctors who supported regional public healthcare is becoming apparent. The number of medical students who entered active service exceeded 1,000 as of last August. The Public Health Officers Association stated on the 10th, “Once the residents begin to enlist, there will be no military medical resources left,” adding, “This is not a political and election-driven healthcare gap, but a real ‘true healthcare gap’ that is coming.”
◇ Medical community: “We will continue to improve training conditions and sustain essential medical care”
The remaining task is to quickly untangle the knots intertwined with conflicts between the government and medical community to alleviate the chaos in the medical field and the harm to patients. There are ongoing calls within the medical community to discuss solutions while separating the increase in medical school enrollment policy from the pressing issues faced by the medical sector.
Medical students and the Korean Medical Association argue that the government should immediately cease all medical school recruitment for next year. Within the medical community, some voices suggest that a ‘2026 freeze’ is realistic, considering social conflicts and admission chaos.
Lee Jin-woo, president of the Korean Academy of Medicine, stated, “It is difficult to gain public sympathy and social agreement on the claim to ‘halt medical school recruitment for 2025 and nullify the increase’ while acceptance lists are being released from each medical school,” adding, “The medical community should work together to freeze the medical school quota at the previous level in 2026 and reflect the conclusions of statistical organizations starting in 2027.”
Opinions have also been raised that the political sphere must continue to implement measures for improving resident training conditions and essential medical reform. The medical association president said, “We must create a proper medical reform to enhance the medical system and training environment,” expressing concerns that the significant political issues may push conflicts between the government and the medical community and medical reform issues to the back burner.
Lee Hyung-min, president of the Korean Society of Emergency Medicine (professor at Ilsan Paik Hospital's Department of Emergency Medicine), stated, “It is true that the announcement of an increase in medical school enrollment was a trigger for the mass resignation of residents, but the residency training system was already in crisis,” adding, “Even if we cancel the increase in medical school enrollment, those who left will not return 100%.” He emphasized the need to improve the training education environment by saying, “We need to provide an environment and opportunities for residents to learn properly.”
The professor noted, “Essential medical reform is the most important task,” and added, “If medical associations and the medical reform special committee discuss together, we will be able to solve the problems through policy.” He stated, “We must establish a system to support essential medical care and ensure that there is a safety net for disputes arising from medical incidents along with improving treatment conditions.”
However, following the recent unilateral cuts to the budget proposed by the opposition party, the budged for support of interns and residents included in the Ministry of Health and Welfare's budget for next year has been reduced by 93.1 billion won compared to the government proposal. This marks the largest cut among the budget reduction items.
Additionally, at the end of August, the Presidential Committee on Medical Reform announced it would push for detailed policy projects to invest 10 trillion won in national finances and 10 trillion won in health insurance for essential and regional healthcare over the next five years, although it remains uncertain whether these plans can be executed as intended. This includes efforts to legally protect the medical practices of essential high-risk areas such as emergency, cardiac, obstetric, and severe pediatric care.