Lee Jae-myung, the Democratic Party of Korea presidential primary candidate, announced 'public medical school' as a healthcare pledge. Once admitted to the public medical school, students will receive tuition support from the state but must work for a certain period in public medical institutions after graduation. The goal is to alleviate regional healthcare disparities and ensure that all citizens can receive treatment without worry when they are ill. The healthcare sector noted that while this system has successful examples in Japan, creating an environment where doctors can work in these regions is a priority.
◇“Training essential and regional healthcare personnel through public medical school”
The candidate posted a 'healthcare policy announcement' on Facebook on the 22nd, stating, “We will establish a public medical school to train essential and regional healthcare personnel and expand public hospitals.” He added, “Although our country has built a high-quality healthcare system in a relatively short time, disparities still exist based on residence,” and “The state will take responsibility for essential medical care such as emergency, childbirth, and trauma treatment.”
Students at the public medical school will be required to care for patients in public medical institutions, such as health centers or military hospitals, after graduating and obtaining their medical licenses with support from the state. The working period is mentioned to be around 10 years.
The candidate did not specify the number of students for the public medical school. Currently, the Medical Workforce Supply and Demand Forecast Committee under the Ministry of Health and Welfare is discussing the number of medical students for the 2027 academic year while estimating how many public medical personnel are needed, and this information is likely to be allocated to the public medical school.
The candidate introduced the public medical school policy fundamentally to gain public support. Over the past year, conflicts in the National Assembly regarding the increase of medical students have arisen as the government has sought to increase the number of doctors to strengthen regional and essential healthcare. However, many expressed that merely increasing the number of doctors would be useless if they concentrated in popular fields like metropolitan areas or dermatology and beauty.
The candidate's camp believes that creating a public medical school can solve the problem of avoidance of regional and essential medical care. Instead of waiting for doctors to voluntarily go into regional or essential medical fields, the plan is to produce doctors who will work in those areas from the beginning.
◇Discussion for 10 years… Failed due to backlash from the medical community
The public medical school has been discussed in the political arena for the past 10 years. Lee Jung-hyun, then a member of the Saenuri Party, and Park Hong-keun of the Democratic Party of Korea proposed the Public Medical School Act in the 19th National Assembly in 2015, but it was scrapped when the Assembly term expired. The law at the time required graduates of the public medical school to work in the region for 10 years.
The Moon Jae-in administration pushed for the establishment of the public medical school in 2018 and 2020. The Ministry of Health and Welfare attempted to create a public medical school by utilizing the 49 slots when the SuNam Medical School in Jeonbuk Namwon closed in 2018, but the medical community objected. Even in 2020, amid the spread of the novel coronavirus pneumonia (COVID-19), there was an attempt to create a public medical school and increase the number of doctors by 4,000 over 10 years, but it also failed due to large-scale strikes by doctors.
The Democratic Party of Korea proposed the Public Medical School Act in July of last year, which would require doctors from the public medical school to work in essential healthcare regions. Civic organizations, such as the National Health and Medical Industry Union, welcomed the establishment of the public medical school. On the other hand, the medical community expressed a cautious stance. They sympathized with the intention to strengthen public healthcare but recognized that the implementation of such a system would not be easy.
Kim Seong-geun, spokesperson for the Korean Medical Association, noted, “To establish just one public medical school, we need to increase the number of professors and find hospitals for practical training, but at present, it is difficult to even secure medical school professors,” and said, “(If we establish a public medical school) it will take 10 years to see results.”
◇Japan's regional medical school, working in hometown for 9 years after graduation
The model for the public medical school is Japan's regional medical schools created in the 1970s. Each of Japan's 47 prefectures selects 2 to 3 students annually, for a total of 120, who must work in their hometowns or rural areas for 9 years after graduation. During the mandatory service period, they hold public servant status.
Students admitted to the regional medical school receive tuition support from the state until graduation. After graduation, they must care for patients at healthcare institutions designated by local governments. If they breach the mandatory service period, they must immediately repay the tuition.
According to a report titled 'Issues and Alternatives in Medical Workforce Policy' published in 2023 by the Korean Association of Medical Colleges and Graduate Schools (KAMC), 99% of 2,958 graduates from cohorts 1-30 of the regional medical school completed their mandatory service. Among the doctors who finished their mandatory service, 67% (1,947) remained in the local area. Based on this, evaluations emerged that the regional medical school strengthened local healthcare.
Experts acknowledge the successful cases of Japan's regional medical schools but believe that fundamentally creating an environment where doctors want to work in the regions is a priority. Ahn Deok-seon, director of the Korean Medical Association's Medical Policy Research Institute, said, “Even if doctors graduate from Japan's regional medical schools and work in the regions, there is still a tendency to want to work near the prefectural office (which is close to urban areas or busy districts),” emphasizing, “We must first consider how to encourage doctors to stay in these regions.”