🚨 Regional Doctor System

Today Korean Social News for Beginners | 2025.11.21

0️⃣ 10-Year Mandatory Service and Regional Healthcare Staffing, Medical Community Opposition

📌 '10-Year Mandatory Service' Regional Doctor System Passes National Assembly Health Committee...Expected to Start with 2027 Medical School Admissions

💬 A bill introducing the Regional Doctor System to solve regional healthcare staffing shortages passed the National Assembly Health and Welfare Committee on November 20, 2025. The bill selects some medical school students through a regional doctor track, provides government support for tuition and living expenses, and requires them to work in designated regional medical facilities for 10 years after graduation. Those who fail to complete their service obligation can have their medical licenses suspended or revoked by the Minister of Health and Welfare, making it highly mandatory. The system is expected to start with the 2027 medical school admissions. The government and patient groups welcome it as an essential policy to improve healthcare access in medically underserved areas, but the medical community strongly opposes it as a hastily made system that ignores reality and claims that staffing without improving working conditions will not be effective.

💡 Summary

• The Regional Doctor System is a program where the government supports medical students and requires them to work in regional medical facilities for 10 years after graduation.
• Those who fail to complete their service can have their licenses suspended or revoked, making it highly mandatory.
• The medical community opposes it, saying staffing without improving working conditions will fail.

1️⃣ Definition

Regional Doctor System means a program where the government selects and supports medical school students or specialists, requiring them to work in medical facilities in medically underserved areas for a certain period after graduation or contract. The official name is 'Act on Training and Support of Regional Doctors'.

This system was introduced to solve the problem of medical staff concentrating in the Seoul metropolitan area and large cities, making it difficult to find doctors in rural and remote areas. Medical students selected as regional doctors receive tuition and living expenses from the government and must work in designated regional medical facilities for 10 years after obtaining their medical license. The system also includes a contract-based regional doctor program for doctors who already have specialist qualifications.

💡 Why is it important?

• It can protect the lives and health of rural and remote area residents by improving their access to healthcare.
• It is a policy tool to reduce medical imbalance caused by concentration in the Seoul metropolitan area.
• As a highly mandatory service system, conflicts with the medical community are expected.
• Staffing without improving working conditions makes long-term effectiveness uncertain.

2️⃣ Background and Main Contents of the Regional Doctor System

📕 Reality of Regional Healthcare Staffing Shortages

• Medical staff are concentrated in the Seoul metropolitan area. Key statistics are as follows:

  • More than half of all doctors in Korea are concentrated in the Seoul metropolitan area including Seoul and Gyeonggi Province.
  • Small and medium-sized cities and rural areas in provinces have difficulty finding doctors, lacking essential medical care.
  • Regional gaps are especially serious in essential departments like pediatrics, obstetrics, and surgery.
  • Rural patients must travel long distances to Seoul metropolitan hospitals for serious illness treatment.

• Regional medical facilities have difficulty securing staff. Key problems are as follows:

  • Rural public hospitals and health centers often receive no applicants even when they post job openings.
  • Doctors avoid these positions because of poor working conditions and lack of educational and cultural infrastructure.
  • Regional medical facilities lack competitiveness due to difficulty investing in modern equipment and facilities.
  • Staff shortages lead to excessive workloads, creating a vicious cycle.

📕 Main Contents of the Bill

• Some medical school freshmen will be selected through the regional doctor track. Main contents are as follows:

  • A certain number of students will be selected annually through the regional doctor track, with specific quotas determined by enforcement decree.
  • Selected students receive tuition and living expenses from the government.
  • After obtaining a medical license and completing specialist training, they must work in designated regions for 10 years.
  • The Minister of Health and Welfare designates working regions and medical facilities, reflecting regional needs.

• Strong penalties are possible for failing to complete service obligations. Main measures are as follows:

  • Those who fail to complete mandatory service receive corrective orders from the Minister of Health and Welfare.
  • If they still fail to comply despite corrective orders, they can receive license suspension for up to one year.
  • Those who receive license suspension three or more times will have their medical licenses revoked.
  • This is stronger than existing administrative penalties under the Medical Service Act, essentially close to forced placement.

• A contract-based regional doctor system for specialists will also be introduced. Key features are as follows:

  • Doctors who already have specialist qualifications can sign contracts to work in regions for a certain period.
  • Contract periods and compensation conditions are determined through negotiation, with incentives provided.
  • Unlike the freshman selection method, this encourages voluntary participation.
  • It is expected to be used to fill short-term staffing gaps.

📕 Opposition and Concerns from the Medical Community

• Critics say it doesn't solve the fundamental problem. Main counterarguments are as follows:

  • Doctors avoid regions not because of staffing shortages but because of poor working conditions.
  • It will be useless without improving the reality of insufficient equipment and facilities and weak educational and cultural infrastructure.
  • There are concerns that few doctors will remain in regions even after completing 10 years of mandatory service.
  • Fundamental measures like improving the medical delivery system and making fees more realistic must be pursued together.

• Forced placement may lower the quality of medical care. Main concerns are as follows:

  • Doctors placed regardless of their will may have low motivation, causing problems with their medical attitudes.
  • Local residents may not want to receive treatment from doctors working reluctantly.
  • Limited specialist training opportunities may negatively affect doctors' capability development.
  • In the long term, it may cause side effects of talented individuals avoiding medical school.

• There are concerns about violating the constitutional freedom to choose one's occupation. Key issues are as follows:

  • Some point out that forcing a working region for 10 years is excessive restriction.
  • Strong sanctions allowing license revocation may violate the principle of proportionality.
  • Even restrictions on basic rights for public interest must follow the principle of minimal infringement.
  • Constitutional complaints or administrative lawsuits are likely to be filed in the future.

💡 Key Issues of the Regional Doctor System

1. Lack of Working Condition Improvements: Limitations of staffing without improving facilities, equipment, and living infrastructure
2. Controversy over Mandatory Nature: Excessive penalties of 10-year mandatory service and possible license revocation
3. Doubts about Effectiveness: Uncertainty about possible departure after mandatory service ends and long-term settlement effects
4. Concerns about Medical Quality: Problems of medical attitude and motivation decline due to involuntary placement
5. Constitutional Issues: Possible violation of freedom to choose occupation and expected future legal disputes

3️⃣ Effective Ways to Revitalize Regional Healthcare

✅ Substantial Improvement of Working Conditions

• Investment in medical infrastructure must be expanded. Main directions are as follows:

  • Government support must be increased so regional medical facilities have modern equipment and facilities.
  • Regional hub hospitals should be fostered to enable high-level medical care.
  • Remote medical systems should be established to enable consultation with metropolitan specialists.
  • Budgets for regular equipment replacement and maintenance must be secured stably.

• Living conditions must be improved to encourage settlement. Key tasks are as follows:

  • Practical incentives like housing support and children's education support must be provided.
  • Regional cultural and educational infrastructure must be expanded to improve quality of life.
  • Family-level settlement programs like spouse employment support and transportation cost support should be prepared.
  • Additional benefits like housing provision or tenure guarantee should be given to long-term workers.

✅ Rational Reorganization of the Medical Delivery System

• Patient classification systems must be strengthened. Main measures are as follows:

  • Mild cases should be encouraged to receive treatment at regional medical facilities first.
  • A system to transfer only severe patients to large hospitals should be established.
  • Co-payments should be increased for visiting large hospitals without going through primary care facilities.
  • A family doctor system should be introduced so patients maintain ongoing relationships with regional doctors.

• Fee systems must be made more realistic. Main improvements are as follows:

  • Medical fees at regional medical facilities should be raised to improve management stability.
  • Compensation for essential medical departments should be strengthened to guide doctors' choices.
  • Proper compensation should be provided for difficult work like night and emergency care.
  • The government should cover public hospital operating deficits to ensure sustainability.

✅ System Design to Encourage Voluntary Participation

• Incentive-centered inducements should be strengthened. Main measures are as follows:

  • Doctors working in regions should be provided with exceptional salaries and treatment.
  • Systems to favor regional work experience after obtaining specialist qualifications should be established.
  • Extra points should be given when hiring at university hospitals or research institutions after completing regional work.
  • Practical compensation like student loan forgiveness and tax benefits should be expanded.

• A gradual and flexible approach is needed. Main suggestions are as follows:

  • Instead of 10 years of mandatory service from the start, methods like 3-5 year renewable contracts should also be considered.
  • Service regions should be designed to partially guarantee personal choice.
  • Work types should be diversified to include not only full-time but also part-time and rotating work.
  • Education systems should be established to enable specialist training in regions.

4️⃣ Related Terms

🔎 Medically Underserved Areas

• Medically underserved areas are regions where accessing medical services is difficult.
  • Medically underserved areas refer to regions where residents have difficulty receiving proper medical services due to shortages of medical facilities and medical staff. Rural areas, island and mountain areas, and depopulated areas are typical examples.
  • Characteristics of medically underserved areas include: first, the number of doctors per population is significantly lower than the national average. Second, essential departments like pediatrics, obstetrics, and surgery are absent or insufficient. Third, it takes a long time to travel to hospitals in emergency situations. Fourth, even when medical facilities exist, their equipment and facilities are outdated.
  • The government designates medically underserved areas and implements policies like dispatching public health doctors, expanding health centers, and supporting medical facilities. However, the problem cannot be solved fundamentally unless doctors settle in these areas, which is why the Regional Doctor System was proposed as an alternative. However, forced placement alone has limitations, and working condition improvements must occur together.

🔎 Mandatory Service System

• The mandatory service system requires service for a certain period in exchange for government support.
  • The mandatory service system refers to a system where the government provides education or training costs in exchange for requiring graduates to work in designated institutions or regions for a certain period. Examples include military medical officers, public health doctors, and public education officials.
  • The Regional Doctor System's mandatory service of 10 years is very long. By comparison: first, public health doctors can freely choose their career after 3 years of service. Second, military medical officers serve about 3 years. Third, teachers who receive scholarships also have mandatory service periods of 5-10 years. Fourth, military academy graduates serve 10 years or more, but they have the special characteristic of being military personnel.
  • Penalties for failing to complete mandatory service are also strong. Generally, scholarship repayment or damage compensation claims for contract violations occur, but the Regional Doctor System allows license suspension or revocation, essentially close to forced placement. This may be controversial regarding whether it complies with the constitutional freedom to choose occupation and the principle against excessive restriction. For the mandatory service system to succeed, reasonable compensation and working condition guarantees must be supported.

🔎 Medical Delivery System

• The medical delivery system is a system that ensures patients receive treatment at appropriate medical facilities.
  • The medical delivery system refers to a system designed for patients to receive treatment step by step at primary (clinics, health centers), secondary (hospitals), and tertiary (advanced general hospitals) medical facilities according to disease severity. The principle is that mild cases are treated at primary medical facilities and severe cases at tertiary medical facilities.
  • Current problems in Korea include: first, patients prefer large hospitals even for mild illnesses, causing overcrowding at large hospitals. Second, primary medical facilities experience management difficulties as patients decrease. Third, severe patients at large hospitals cannot receive proper treatment because they are crowded out. Fourth, medical gaps between large cities and provinces are intensifying.
  • Measures to correct the medical delivery system include: first, co-payments should be increased for visiting large hospitals without going through primary medical facilities. Second, a family doctor system should be introduced to encourage patients to have regular doctors. Third, the medical capacity of regional medical facilities should be strengthened to increase trust. Fourth, remote medicine and consultation systems should enable high-level medical care even at regional medical facilities. The Regional Doctor System should be promoted together with such medical delivery system reforms to be effective.

🔎 Public Medical School

• Public medical school was a medical school intended to be established for training public healthcare personnel.
  • Public medical school refers to a medical school established by the national or local government to train doctors who will dedicate themselves to regional and public healthcare. The government pushed for establishing a public medical school along with increasing medical school quotas in 2020, but it was scrapped due to strong opposition from the medical community.
  • The purpose of establishing a public medical school was: first, to systematically train doctors who will dedicate themselves to regional and essential medical fields. Second, unlike existing private medical schools, it planned to operate a curriculum emphasizing public nature. Third, it intended to solve medical imbalance by mandatorily placing graduates in public hospitals or health centers. Fourth, it aimed to establish a foundation for strengthening medical public nature in the long term.
  • The reason public medical school establishment failed was opposition from the medical community. The medical community worried that increasing the number of doctors would lead to lower medical quality and excessive competition, and argued that public medical school could distort the medical market. Eventually, the government withdrew public medical school establishment and instead pushed for the Regional Doctor System as an alternative. The Regional Doctor System tried to reduce medical community opposition by selecting within existing medical school quotas without creating new medical schools, but controversy remains over the forced placement method.

5️⃣ Frequently Asked Questions (FAQ)

Q: What benefits do you receive if selected as a regional doctor?

A: The government supports tuition and living expenses, and specialist training courses are also guaranteed.

• Medical students selected as regional doctors receive full government support for 6 years of medical school tuition and living expenses. Medical school tuition is about 10 million won per year, so over 6 years it's an economic benefit of over 60 million won. Living expenses are also supported at a certain amount, allowing students to focus on their studies without financial burden.
• After graduation, they can complete specialist training courses, and training hospitals are also guaranteed. However, training courses are also likely to take place at regional hospitals. During the 10 years of mandatory service, they must work at designated regional medical facilities, but salaries and treatment are expected to be guaranteed at equal or better levels than general doctors. However, the disadvantages are that working regions are limited and they must complete 10 years of long-term mandatory service.

Q: What happens if you don't complete 10 years of mandatory service?

A: You can receive license suspension after corrective orders, and licenses are revoked after 3 or more times.

• If you fail to complete mandatory service, you first receive corrective orders from the Minister of Health and Welfare. Corrective orders are administrative orders to complete mandatory service within a certain deadline. If you refuse service despite corrective orders, you can receive license suspension for up to one year. While your license is suspended, you cannot perform medical acts during that period.
• If you receive license suspension 3 or more times, your medical license itself is revoked. License revocation is a very strong sanction that can only be recovered by passing the medical national examination again. It essentially means the end of your career as a doctor. You will also likely be obligated to return government support funds. Because such strong sanctions are possible, it is essentially close to forced placement, raising controversy about violation of the constitutional freedom to choose occupation.

Q: What conditions are needed for the Regional Doctor System to succeed?

A: Working condition improvements, proper compensation, and medical delivery system reform must occur together.

• For the Regional Doctor System to succeed: first, working conditions at regional medical facilities must be substantially improved. Modern medical equipment and facilities must be provided, and sufficient staff must be deployed to reduce excessive work burdens. Second, proper compensation for regional work must be provided. Salaries should be made realistic, and practical incentives like housing, education, and cultural support should be provided. Third, the medical delivery system should be reformed to encourage mild cases to receive treatment at regional medical facilities.
• Also, educational opportunities and research environments where regional doctors can develop their expertise must be provided. Remote medical systems should be established to enable consultation with metropolitan specialists, and regular continuing education and conference participation should be supported. Most importantly, the system should be designed to encourage voluntary participation rather than force. If regional work helps careers and quality of life is also guaranteed, the possibility of remaining in regions even after mandatory service ends increases. Staffing alone has limitations, and comprehensive regional healthcare revitalization policies must be supported.

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