Government: “Anything except increasing the number of medical schools can be discussed this year”

Regarding the controversy surrounding the expansion of medical school quota, the government stated on the 25th, “Any discussion is possible except for the quota for the 2025 school year, which cannot be adjusted due to the schedule.” The Ministry of Health and Welfare and the Ministry of Education issued a press release this afternoon, saying, “The government has repeatedly stated that discussions can be held at any time if the medical community presents a unified plan based on rational and scientific grounds.” It officially announced the government’s position that ‘if the medical community comes with a single plan to increase the number of students, the scale of medical school expansion after the 2026 school year can be re-discussed with the medical community.’

The government also said, “As the Presidential Special Committee on Medical Reform, which was launched on the 25th, is also dealing with the mechanism for adjusting the supply and demand of medical personnel as an agenda, the Korean Medical Association (KMA) and the Korean Medical Residents Association (Daejeon Medical Association) are participating in the special committee on medical reform and presenting reasonable opinions.” “Please do it,” he said.

The Medical Reform Special Committee, chaired by Noh Yeon-hong, president of the Korea Pharmaceutical and Biotechnology Association, and comprised of a total of 27 members, including 6 government members and 20 private members, held its first meeting on this day. However, among these, the Korean Medical Association, Daejeon Medical Association, and the Korean Academy of Medical Sciences declared their absence from the special committee and did not appear at the meeting that day. The Korean Medical Association’s position is, “Increasing the number of medical schools is a problem that must be resolved through one-on-one meetings between the government and the medical community.”

After the meeting, Chairman Noh Yeon-hong said, “The special committee is an organization that discusses the medical system and system reform in a larger framework.” He added, “The special committee can share opinions on the mechanism for adjusting the supply and demand of medical personnel, but it does not discuss the specific number of medical school seats (for now).” “I have no plans to do so,” he said. This means that the special committee will discuss ways to form a consultative body that periodically investigates and studies the number of doctors needed in the future, and that the government should specifically decide how many doctors to increase or decrease based on the ‘required number of doctors’ determined by this consultative body.

Chairman Roh also announced that he would announce a specific roadmap for four major medical reform tasks in the first half of the year, including strengthening compensation for severe and essential medical care, normalizing the medical delivery system, introducing a national responsibility system for resident training, and strengthening the medical accident safety net.

First, the fees for critical and essential medical services such as severe emergency, severe psychiatric, pediatric, and childbirth and local medical services (money given to hospitals by the National Health Insurance Corporation) will be significantly increased, and patients with mild symptoms will be treated at 1, 1, 2, 3 hospitals instead of general hospitals (large tertiary hospitals). It appears that measures to encourage the use of secondary medical institutions will be concreted. A key task is to improve the working conditions of medical residents by reducing the ratio of medical residents at tertiary general hospitals from about 40% to 20%. In addition, it is expected that full-fledged discussions will be held on reforming actual cost insurance that encourages excessive uncompensated treatment and enacting a medical accident special law that lowers the burden of lawsuits on doctors in essential departments. Chairman Roh said, “As a partner in medical reform, I request the participation of the Korean Medical Association and Daejeon Medical Association in the special committee as soon as possible.”

Although the Special Committee on Medical Reform was inaugurated on this day, the conflict over legislation has hardly been resolved. This is because while the government has taken a step back with ‘autonomous increase in number of students by university for the 2025 school year’ and ‘re-discussion of increase in number from the 2026 school year,’ medical groups and medical school professors are sticking to ‘freezing the number of medical school students for the 2025 school year and canceling the policy to increase the number of students.’ Jeon Byeong-wang, head of the Health and Medical Policy Department of the Ministry of Health and Welfare, rejected the ‘freeze and reexamination of the 2025 school year’, saying, “It is difficult to see it as a reasonable alternative.”

The 25th is the day when ‘automatic resignation’ under civil law begins for medical school professors who are the first to submit a letter of resignation. Medical school professors claim, “According to civil law, a resignation becomes effective one month after the resignation letter is submitted.” The government’s position is, “Full-time medical school professors with guaranteed retirement age are not subject to ‘automatic resignation’ because they are subject to special laws such as the National Public Officials Act, which takes precedence over the Civil Act.” This means that if the resignation is not accepted, he will not be able to leave the hospital voluntarily. However, some professors have announced, “I will leave the hospital next month regardless of whether my resignation is accepted.”

Professors are also gradually increasing the level of their ‘law compliance struggle.’ Following the announcement of the policy of ’52 hours of treatment per week’ from the 25th of last month and ‘minimization of outpatient treatment’ from the 1st of this month, professors at many university hospitals, including the Big 5 (Seoul National University, Seoul Asan, Severance, Samsung Seoul, and Seoul St. Mary’s) hospitals, will be appointed starting next week. They can take a break once a week. Seoul National University Medical School professors, who decided to close on the 30th, will soon discuss whether to close once a week again. Professors at Yonsei University Medical School will be closed on the 30th, and professors at Ulsan University Medical School will be closed once a week starting on the 3rd of next month. Ulsan University medical school professors said, “Problems have arisen in raising children due to continuous medical treatment and on-call duties,” and added, “Professors are planning to apply for childcare leave of one month to up to two years.” As controversy arose regarding the effectiveness of the resignation letter, he announced that he would use parental leave.

Patients’ anxiety is increasing. On this day, the Korean Federation of Patient Organizations said to the medical community, “The anxiety and damage suffered by emergency and severe patients due to delayed treatment, as well as the embarrassment and anger of the patients’ families, are beyond imagination,” and asked them to “please remain in the medical field.”

The government’s stance is that it will significantly strengthen support for essential medical services that are urgently needed, regardless of the discussion by the special committee on medical reform. This year alone, more than 1.4 trillion won will be invested to support essential medical care. The Ministry of Health and Welfare held a health insurance policy deliberation committee meeting on this day and announced that it would strengthen support for 20 high-risk maternal and newborn integrated treatment centers, including establishing a ‘high-risk pregnant woman policy fee’ that provides support of 200,000 won per day for up to 7 days per high-risk pregnant hospitalized patient. .

At this meeting, the 2024 implementation plan according to the National Health Insurance Comprehensive Plan was also reviewed. Accordingly, in the first quarter, more than 1.12 trillion won was invested in areas such as childbirth, pediatrics, and severe emergency, and in the second quarter, fees for high-level surgical procedures will be increased. In addition, in the third quarter, hospitalization fees for patients with severe mental illness will be increased, and in the fourth quarter, post-compensation for public specialized treatment centers for children will be provided. Instead of expanding essential medical support, starting in July, health insurance financial management will be strengthened, such as raising the co-payment rate to 90% for patients who receive outpatient treatment more than 365 times a year.