🚨 Regional Doctor System

Today Korean Social News for Beginners | 2025.10.10

0️⃣ Healthcare Workforce Imbalance and Constitutional Concerns

📌 Government Officials Give Conflicting Statements on Regional Doctor System's Constitutionality

💬 The Ministry of Health and Welfare's Regional Doctor System is facing serious constitutional concerns. The Health Minister said "there is almost no constitutional problem because applicants know the requirements when they apply." However, the Vice Minister said "we received legal advice that the license cancellation clause may be unconstitutional." Public hearings have been delayed, making it unlikely the bill will pass this year. The medical community strongly opposes the system, saying it violates freedom of occupation and freedom of residence. They may file a constitutional complaint.

💡 Summary

• The Regional Doctor System requires students to work in underserved areas for 10 years after entering medical school.
• Even within the government, opinions differ on whether the system is constitutional.
• Key issues include violation of freedom of occupation, freedom of residence, and excessive punishment through license cancellation.

1️⃣ Definition

The Regional Doctor System is a program where medical students promise to work in underserved areas for 10 years starting from when they enter medical school. After getting their medical license, they must work in the designated area. If they don't fulfill this requirement, they can face penalties including license suspension or cancellation.

The government wants to solve the problem of doctors being concentrated in big cities while rural and small cities lack doctors. However, medical and legal experts criticize it as an unconstitutional system that excessively restricts individual basic rights.

💡 Why is this important?

• It's an important policy to guarantee healthcare access for people in underserved areas.
• It conflicts with freedom of occupation and freedom of residence guaranteed by the Constitution.
• It determines the direction of healthcare workforce training policy.
• It could set a precedent for similar systems in other professional fields.

2️⃣ Content and Background of the Regional Doctor System

📕 Main Content of the System

• The mandatory service requirements are clearly defined. Main points include:

  • Students are selected after promising to work in a specific area for 10 years from the time they enter medical school.
  • After getting their medical license, they must immediately start working at healthcare facilities in that area.
  • During the service period, working or opening a practice in other areas is prohibited.
  • Specialist training must also be completed within that designated area.
  • They can only move to other areas after completing the 10-year mandatory service.

• Strong penalties are imposed for violations. Main penalties include:

  • Medical licenses can be suspended or cancelled if mandatory service is not fulfilled.
  • If they leave during the mandatory service period, they must return scholarships and other support received.
  • Administrative and legal sanctions are applied for violating service obligations.
  • License cancellation is an extreme measure that completely takes away their career as a doctor.

📕 Reality of Healthcare Workforce Imbalance

• The gap in doctor numbers between regions is serious. Key facts include:

  • Seoul has 3.5 doctors per 1,000 people, while South Chungcheong, South Jeolla, and North Gyeongsang provinces have less than 2 doctors.
  • More than half of all doctors are concentrated in the Seoul metropolitan area.
  • Rural areas and small cities have difficulty finding doctors in essential medical fields.
  • The regional gap is especially large in obstetrics, pediatrics, and surgery.
  • Medical blind spots exist where people must travel to big cities in emergencies.

• The problem persists despite various government policies. Main issues include:

  • Existing policies like public health doctors and regional fee increases have had low effectiveness.
  • Doctors prefer big cities due to training environment, educational opportunities, and living conditions.
  • When opening a practice, big cities are more advantageous considering patient numbers and profitability.
  • Support and incentives for doctors working in rural areas have not been sufficient.
  • These structural problems have made healthcare imbalance permanent.

💡 Main Causes of Regional Healthcare Workforce Imbalance

1. Training Environment: Rural hospitals lack training infrastructure compared to big city hospitals
2. Educational Opportunities: Limited access to continuing education and academic activities after becoming specialists
3. Living Conditions: Lack of life infrastructure like children's education and cultural activities
4. Economic Factors: Big cities are much more advantageous in patient numbers and profitability
5. Social Perception: Cultural atmosphere that avoids working in rural areas

3️⃣ Constitutional Controversy and Key Issues

✅ Analysis of Constitutional Issues

• Violation of freedom of occupation is the core issue. Key points include:

  • Article 15 of the Constitution guarantees freedom of occupation to all citizens.
  • The Regional Doctor System violates this freedom by restricting work location and medical field for a long time.
  • Even though it's voluntary application, 10 years is an excessive restriction.
  • There is an essential restriction in that they get a medical license but cannot use it freely.

• Restriction of freedom of residence is also problematic. Key points include:

  • Article 14 of the Constitution guarantees freedom of residence and movement as a basic right.
  • Forcing people to live and work in a specific area for 10 years restricts this freedom.
  • Freedom to decide one's lifestyle, including family life and children's education, is violated.
  • Flexible response to life cycle changes like marriage and childbirth becomes difficult.

✅ Controversy Over Violation of Prohibition of Excessive Restriction

• The license cancellation clause is the biggest issue. Main problems include:

  • Article 37, Paragraph 2 of the Constitution states that basic rights must be restricted to the minimum necessary.
  • Medical license cancellation is an extreme sanction that makes years of education and effort meaningless.
  • Other alternative sanctions like license suspension or fines are fully possible.
  • License cancellation is excessive when the least invasive means should be chosen to achieve the purpose.
  • Even the Vice Minister of Health acknowledged this point through legal consultation.

• Review of proportionality principle is needed. Key perspectives include:

  • Legitimacy of purpose: The purpose of supporting underserved areas can be considered legitimate.
  • Appropriateness of method: Verification is needed on whether mandatory service is actually effective in solving doctor shortage.
  • Minimization of harm: Judgment is needed on whether 10 years and license cancellation are excessive.
  • Balance of interests: Comparison is needed between public interest of improving regional healthcare and restriction of individual basic rights.
  • Overall, the consensus in the legal community is that there is a high possibility of violating the prohibition of excessive restriction.

✅ Conflicting Positions Within the Ministry and Future Outlook

• Opinions are not unified even within the government. Key situations include:

  • The Minister stated "there is almost no constitutional problem because it's voluntary application."
  • However, the Vice Minister disclosed legal advice results that "the license cancellation clause has constitutional concerns."
  • These conflicting statements raise questions about the government's policy implementation will and legal stability.
  • Public hearings have been postponed several times, preventing sufficient social discussion.

• Bill passage and future outlook are uncertain. Key forecasts include:

  • The goal was to pass it during the regular session this year, but the possibility has decreased due to controversy.
  • The medical community collectively opposes it and has announced plans to file a constitutional complaint.
  • Even if the bill passes, there is a high possibility of the Constitutional Court ruling it unconstitutional.
  • If a constitutional non-conformity decision is made, the core content of the system must be revised.
  • The government must prepare supplementary measures or consider alternative policies.

4️⃣ Related Terms Explained

🔎 Freedom of Occupation

• Freedom of occupation is a basic right guaranteed by the Constitution.
  • Freedom of occupation is a basic right guaranteed by Article 15 of the Constitution, meaning all citizens have the right to freely choose and engage in occupations according to their aptitude and ability. Here, occupation means continuous income activities to meet basic life needs.
  • Freedom of occupation includes three main elements. First, freedom to choose occupation - the right to decide what occupation to choose. Second, freedom to practice occupation - the right to freely practice the chosen occupation. Third, freedom to change jobs - the freedom to change or quit occupations.
  • However, this freedom is not absolute and can be restricted by law for public welfare. But even when restricting, constitutional limits like prohibition of excessive restriction and prohibition of violating essential content must be observed. The Regional Doctor System is evaluated as significantly restricting this freedom by limiting work location and method for 10 years.

🔎 Freedom of Residence and Movement

• Freedom of residence is the right to choose one's lifestyle.
  • Freedom of residence and movement is a basic right guaranteed by Article 14 of the Constitution, meaning all citizens have the right to freely choose their residence and move. This means freedom to live and work in the place they want, and is a basic right for human-like living.
  • Freedom of residence includes several aspects. First, freedom to choose residence - can establish residence anywhere in the country. Second, freedom to travel - can freely move within the country. Third, freedom to travel abroad and emigrate is also included. Fourth, freedom to return home - the right to return to Korea is also recognized.
  • The Regional Doctor System directly restricts this freedom by forcing people to live and work in a specific area for 10 years. They cannot freely plan their lives regarding family situation changes, children's education, spouse's workplace, etc. The Constitutional Court views freedom of residence as a very important basic right, so restrictions on this receive strict review.

🔎 Prohibition of Excessive Restriction

• Prohibition of excessive restriction is a principle that sets limits on basic rights restrictions.
  • Prohibition of excessive restriction is a constitutional principle that the state must follow when legislating to restrict citizens' basic rights, meaning restrictions must be kept to the minimum necessary. It is based on Article 37, Paragraph 2 of the Constitution which states "The freedoms and rights of citizens may be restricted by law only when necessary for national security, order maintenance, or public welfare, and even when restricted, the essential content of freedom and rights cannot be violated."
  • Prohibition of excessive restriction consists of four sub-principles. First, legitimacy of purpose - the purpose of basic rights restriction must conform to the Constitution and laws. Second, appropriateness of method - the means must be effective and appropriate for achieving the purpose. Third, minimization of harm - among various means to achieve the purpose, the one that least infringes on basic rights must be chosen. Fourth, balance of interests - the public interest to be achieved and the private interest infringed must be balanced.
  • The license cancellation clause in the Regional Doctor System is problematic especially in terms of minimization of harm. This is because less invasive means such as fines or license suspension are possible for non-fulfillment of mandatory service, yet the extreme means of license cancellation was chosen. Since this takes away the entire career as a doctor, experts evaluate that the possibility of violating prohibition of excessive restriction is very high.

🔎 Constitutional Complaint

• Constitutional complaint is a remedy for basic rights violations.
  • Constitutional complaint is a system where those whose constitutional basic rights are violated by exercise or non-exercise of public power petition the Constitutional Court for remedy. Based on Article 68 of the Constitutional Court Act, it functions as the last resort to protect citizens' basic rights.
  • There are two main types of constitutional complaints. First, rights remedy constitutional complaint challenges basic rights violations by acts of public power such as laws, orders, and dispositions. Second, constitutional complaint against refusal to refer unconstitutional law review can be filed when courts refuse to refer unconstitutional law review. If the Regional Doctor System is enacted as law, there is a high possibility of rights remedy constitutional complaints being filed against it.
  • The Constitutional Court can make four types of decisions after reviewing whether a law violates the Constitution. First, constitutional decision when judged to have no problems. Second, unconstitutional decision that immediately invalidates it. Third, constitutional non-conformity decision that requires improvement legislation within a certain period. Fourth, limited unconstitutional/limited constitutional decision that judges unconstitutional or constitutional only for specific interpretations. For the Regional Doctor System, there is a possibility of unconstitutional or constitutional non-conformity decisions regarding the license cancellation clause.

5️⃣ Frequently Asked Questions (FAQ)

Q: What benefits do you get if you apply to the Regional Doctor System?

A: Benefits include scholarship support, guaranteed specialist training, and regional settlement support.

• If selected for the Regional Doctor System, you can receive various benefits. First, full scholarships are provided during medical school, greatly reducing financial burden. Regular medical students spend tens of millions of won on tuition and living expenses, but regional doctors receive support for these. Second, specialist training is guaranteed, allowing you to become a specialist in your desired field. Considering the difficulty of getting specialist training opportunities, this is a big advantage. Third, various incentives are provided when opening a practice or working in that area, including settlement support funds, housing support, and children's education expense support. Fourth, after 10 years of mandatory service, you can freely practice without restrictions.
• However, despite these benefits, many medical school applicants are expected to hesitate to apply because their location and practice method are restricted for 10 years, and violation results in the extreme sanction of license cancellation. Whether enough applicants can be secured even if the system is implemented remains uncertain.

Q: Do other countries have systems like the Regional Doctor System?

A: Several countries operate similar systems, but most are incentive-based and less coercive.

• Regional healthcare workforce imbalance is a common problem many countries face, and various policies are implemented. First, the United States operates the National Health Service Corps (NHSC) program that uses an incentive method of forgiving student loans if you work in underserved areas for a certain period. There is no coercion and it depends on voluntary choice. Second, Australia selects a certain proportion of medical school admissions from regional students and encourages regional settlement through regional training programs. This is also not coercive. Third, Japan operates a regional medical school quota system to train doctors needed in each region. Fourth, Canada provides economic incentives such as high fees and tax reductions to doctors working in rural areas.
• The common feature of these countries is that they induce voluntary participation through incentives. Strong sanctions like license cancellation as in Korea are rare. Experts point out that inducing voluntary settlement in rural areas through improving working environment, appropriate compensation, and career development opportunities is more effective than coercion.

Q: Will the Regional Doctor System solve the underserved area problem if implemented?

A: It may have some short-term effect, but is difficult to be a fundamental solution.

• Even if the Regional Doctor System is implemented, it will be difficult to completely solve the underserved area problem. First, due to constitutional controversy, actual implementation is uncertain and there is a high possibility of the Constitutional Court ruling it unconstitutional. Second, even if implemented, it's questionable whether enough applicants can be secured. The 10-year mandatory service and license cancellation sanction will be a big burden for medical school applicants. Third, after the 10-year mandatory service period ends, there is a high possibility of moving back to big cities, making it not a long-term solution. Fourth, just increasing the number of doctors is insufficient - facilities and equipment of regional medical institutions, training environment, and life infrastructure must also be improved together.
• Experts point out that a comprehensive approach is needed for fundamental solutions. Financial support expansion for regional hospitals, substantial compensation strengthening for doctors working in rural areas, introduction of new healthcare delivery systems like telemedicine, qualitative improvement of regional training programs, and life infrastructure improvement must all be achieved together. Creating an environment that makes people want to work in rural areas is more important than coercive mandatory service.

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