🚨 Regional Doctor System

Today Korean Social News for Beginners | 2026.01.19

0️⃣ Medical School Expansion and Challenges in Reducing Regional Healthcare Disparities

📌 Government Confirms Regional Doctor System for All Medical School Expansion, Medical Community Points to Insufficient Preparation

💬 The government has decided to select all newly added medical school seats starting from the 2027 academic year through the Regional Doctor System. The goal is to address the shortage of healthcare workers in regional, essential, and public healthcare. The Regional Doctor System provides medical students with tuition and living expenses in exchange for mandatory service in medically underserved areas or essential medical fields after graduation. However, the medical community is pushing back, questioning the reliability of doctor supply projections and citing lack of policy preparation. A government research institute pointed out that simply increasing workforce numbers has limitations, and the entire regional healthcare compensation system should be redesigned with a function-based approach. Challenges remain in preventing doctors from leaving regions after mandatory service and expanding educational infrastructure at regional medical schools.

💡 Summary

• The Regional Doctor System provides tuition support in exchange for mandatory service in medically underserved areas after graduation.
• The government plans to select all newly added medical school seats through the Regional Doctor System starting from 2027.
• The medical community questions effectiveness, citing concerns about supply projection reliability and inadequate compensation systems.

1️⃣ Definition

The Regional Doctor System is a doctor training program that selects a certain percentage of medical school students separately, provides tuition and living expenses, and requires them to work in medically underserved areas or essential medical fields for a set period after obtaining their medical license. The official name is 'Regional Doctor Selection System', and its purpose is to reduce regional healthcare disparities and strengthen public healthcare infrastructure.

The core of the system is an exchange relationship between scholarship support and mandatory service. Students are selected as regional doctors from admission and receive tuition, living expenses, and textbook costs throughout their studies. After graduation, they must complete a mandatory service period of typically around 10 years at designated public hospitals or health centers in medically underserved areas or essential medical fields. If they fail to fulfill this obligation, they must repay the scholarship with interest.

💡 Why is this important?

• It distributes medical workforce concentrated in Seoul and major cities to regional areas, improving healthcare equity.
• It can alleviate workforce shortages in essential medical fields like obstetrics, pediatrics, and emergency medicine.
• It improves healthcare accessibility for residents in medically underserved areas and guarantees their right to health.
• However, challenges remain in regional retention after mandatory service and expanding educational infrastructure.

2️⃣ Current Status and Issues of the Regional Doctor System

📕 Medical School Expansion and Full Application of Regional Doctor System

• The government has decided to significantly increase medical school enrollment. Key details include:

  • Starting from the 2025 academic year, medical school enrollment will increase from 3,058 to about 5,000 annually by adding approximately 2,000 seats.
  • The additional seats will mainly be allocated to regional medical schools to strengthen regional healthcare workforce training.
  • The government maintains that increasing doctor workforce is essential to respond to population aging and growing healthcare demand.
  • The medical community opposes, arguing the expansion scale is excessive and ignores educational conditions.

• All additional seats will be selected through the Regional Doctor System starting from 2027. Key policies include:

  • Previously, only some seats used the Regional Doctor System, but this will expand to all additional seats.
  • This aims to structure the expanded workforce to actually be deployed in regional and essential healthcare.
  • Students will clearly understand mandatory service conditions from admission.
  • Methods are being reviewed to assign mandatory service regions and medical specialties based on regional and field-specific needs.

📕 Workforce Shortage in Medically Underserved Areas

• Regional healthcare disparities are severe. Key situations include:

  • Medical workforce is concentrated in Seoul, the metropolitan area, and major cities, while rural areas suffer from chronic shortages.
  • Especially in farming, fishing, and mountain villages, hospitals themselves are scarce and recruiting doctors is difficult.
  • Regional public hospitals struggle to secure specialists, leading to reduced medical departments or closures.
  • Even in emergencies, appropriate treatment is often unavailable, requiring transfer to major cities.

• Avoidance of essential medical fields is intensifying. Key problems include:

  • Essential medical fields like obstetrics, pediatrics, emergency medicine, and surgery are avoided due to heavy workload and low fees.
  • Particularly in rural areas, essential medical services often cease operation due to workforce shortages.
  • High medical malpractice risk and poor working conditions are not adequately compensated.
  • New doctors strongly prefer profitable fields like dermatology, plastic surgery, and ophthalmology.

📕 Limitations of Compensation System and Policy Design

• Current compensation system disadvantages regional healthcare. Key issues include:

  • Fee-for-service payment system disadvantages regional hospitals with fewer patients.
  • To maintain essential medical functions, operating costs should be covered regardless of patient volume, but this is not the reality.
  • Financial incentives exist for regional and essential healthcare, but are insufficient for doctors to feel.
  • National research institutes suggest transitioning to a function-based compensation system.

• Regional healthcare support policies are duplicative and inefficient. Key criticisms include:

  • Multiple ministries and agencies run similar regional healthcare support programs, creating duplicate support.
  • Mixed purposes of ensuring safety net and achieving equity disperse policy effectiveness.
  • Field workers struggle to understand available support and face increased administrative burden.
  • Opinions suggest establishing integrated management system at higher level and redesigning policies by purpose.

📕 Medical Community's Concerns and Opposition

• There is controversy over reliability of doctor supply projections. Key issues include:

  • The government promoted expansion based on projections of 10,000 doctor shortage by 2035.
  • The medical community argues the projection methodology is weak and variable settings are arbitrary, making it unreliable.
  • Critics point to overestimation of healthcare demand growth and failure to consider efficiency improvements from medical technology advances.
  • Conflict continues due to lack of agreement on basic data and methodology between government and medical community.

• Concerns exist about insufficient educational infrastructure at regional medical schools. Key problems include:

  • Rapid increase in medical school enrollment could lead to shortages in faculty, training beds, and educational facilities.
  • Regional medical schools particularly have weaker infrastructure compared to Seoul-based schools, raising concerns about educational quality gaps.
  • Declining education quality could ultimately lead to deterioration in healthcare service quality.
  • The government promised financial support for educational infrastructure expansion, but specific plans and implementation remain unclear.

• It's difficult to prevent regional exodus after mandatory service. Key limitations include:

  • Mandatory service period is limited, with no way to prevent relocation to major cities after completion.
  • Fundamentally, if regional living conditions and educational environment don't improve, settlement incentives are insufficient.
  • Comprehensive settlement conditions including spouse employment, children's education, and cultural life must be supported.
  • Settlement support policies are needed to prevent mandatory service from becoming merely a "rite of passage" before leaving.

💡 Key Issues of Regional Doctor System

1. Supply Projection Controversy: Differing views between government and medical community on doctor shortage scale
2. Educational Infrastructure: Concerns about educational conditions at regional medical schools due to rapid enrollment increase
3. Compensation System: Patient volume-based fees disadvantage regional and essential healthcare
4. Policy Duplication: Similar programs across ministries cause inefficiency and confusion
5. Settlement Incentives: Lack of effective measures to prevent regional exodus after mandatory service

3️⃣ Improvement Measures for Ensuring Effectiveness

✅ Fundamental Reform of Compensation System

• Must transition to function-based compensation system. Key directions include:

  • Hospitals maintaining essential medical functions should receive institutional operating cost support even with low patient volume.
  • Separate compensation should be provided for performing specific functions like emergency room operation and childbirth services.
  • Substantially attractive compensation should be provided to doctors working in regional and essential healthcare.
  • Overall fee system should be reviewed to properly evaluate the value of essential healthcare.

• Integrated policy design and management are needed. Key tasks include:

  • Safety net assurance (providing minimum healthcare) and equity assurance (reducing regional gaps) should be separated by purpose.
  • Duplicate regional healthcare support programs should be consolidated and operated with consistent standards.
  • A dedicated organization for regional and essential healthcare should be established within the Ministry of Health and Welfare for integrated management.
  • Customized policies fitting regional characteristics should be designed in cooperation with local governments.

✅ Educational Infrastructure Expansion and Quality Management

• Regional medical school educational conditions must be significantly improved. Key measures include:

  • Faculty should be sufficiently secured according to expansion scale and their treatment improved.
  • Training hospitals and beds should be expanded so students can gain sufficient clinical experience.
  • Physical infrastructure including educational facilities, research equipment, and libraries should be expanded.
  • The government should execute promised financial support quickly and transparently.

• Medical education quality management system should be strengthened. Key directions include:

  • Korean Institute of Medical Education and Evaluation's evaluation standards should be strengthened to ensure education quality.
  • Whether expanded enrollment was reasonably distributed considering educational conditions should be monitored.
  • Graduates' competencies should be objectively evaluated and supplementary education provided where insufficient.
  • Long-term, national medical examination system should be improved to verify skills.

✅ Regional Settlement Support Policy

• Incentives must be provided to remain in regions even after mandatory service. Key tasks include:

  • Support should be provided so doctors can settle based on careers and networks built during service period.
  • Comprehensive settlement packages including hospital opening funds, housing purchase support, and children's education expenses should be provided.
  • Environments should be created where doctors can learn latest medical technology and conduct research even in regions.
  • Cooperation with local governments is needed to improve living conditions for doctors' families.

• Overall regional healthcare infrastructure must be improved. Key directions include:

  • Outdated regional hospital facilities should be modernized and equipped with latest equipment.
  • Cooperation systems among medical staff should be established to reduce isolation and enable mutual support.
  • Telemedicine and digital healthcare should be utilized to improve regional healthcare quality.
  • Medical literacy of regional residents should be enhanced to enable appropriate healthcare utilization.

✅ Social Agreement and Long-term Roadmap

• Government and medical community must restore trust. Key measures include:

  • Doctor supply projection methodology should be disclosed and verified by external experts.
  • Government should show attitude of listening to medical community's reasonable concerns and reflecting them in policy.
  • Policy should be designed through sufficient discussion and agreement rather than unilateral promotion.
  • Policy promotion process and results should be transparently disclosed to build trust.

• Phased and systematic implementation plan is needed. Key content includes:

  • Short-term focus should be on educational infrastructure expansion and compensation system improvement.
  • Medium-term should accumulate regional doctor system operation experience and supplement the system.
  • Long-term should improve overall regional healthcare ecosystem to ensure sustainability.
  • Performance should be evaluated and feedback provided at each stage to improve policy.

4️⃣ Related Terms

🔎 Medically Underserved Areas

• Medically underserved areas are regions where access to medical services is difficult.
  • Medically underserved areas refer to regions where residents struggle to receive appropriate medical services due to insufficient medical institutions or significantly lacking doctor workforce. Legally defined in the "Act on Public Health and Medical Services."
  • Key criteria include: First, regions with doctor-to-population ratio significantly lower than national average. Second, regions with excessive average distance or travel time to medical institutions. Third, regions without medical institutions for specific specialties (obstetrics, pediatrics, etc.). Fourth, regions with inadequate emergency medical system making treatment within golden time difficult.
  • Medically underserved areas are mainly farming, fishing, and mountain villages, islands, and other areas with low population density and poor accessibility. In these regions, even if doctors open practices, few patients make management difficult, and insufficient cultural life and educational conditions make doctor recruitment hard. The government promotes various policies including public healthcare expansion, telemedicine support, and medical personnel dispatch, with the Regional Doctor System being part of these efforts.

🔎 Essential Healthcare

• Essential healthcare refers to medical fields necessary for national health but avoided by doctors.
  • Essential healthcare refers to medical fields absolutely necessary for protecting citizens' lives and health but avoided by doctors due to low profitability or heavy workload. Representative fields include emergency medicine, obstetrics, pediatrics, surgery, thoracic surgery, and neurosurgery.
  • Reasons for avoiding essential healthcare include: First, heavy workload including night duties and emergency response. Second, high medical malpractice risk with high exposure to legal disputes. Third, low fee rates resulting in poor profitability. Fourth, vicious cycle of workforce shortage due to resident avoidance.
  • Essential healthcare collapse directly threatens citizens' right to health. Situations arise where appropriate treatment cannot be received in emergency rooms, no obstetrics department can be found for childbirth, or no pediatrics is available to treat sick children. The government promotes multifaceted measures including essential healthcare fee increases, medical dispute burden reduction, and working condition improvement, while attempting to secure essential healthcare workforce through the Regional Doctor System.

🔎 Doctor Supply Projection

• Doctor supply projection means predicting future doctor workforce shortage or surplus.
  • Doctor supply projection is work predicting whether doctors will be insufficient or excessive at certain future point by considering current doctor numbers, output rate, future healthcare demand changes, etc. It becomes important basis for government's medical workforce policy formulation.
  • Projection methodology includes: First, demand-based projection calculates needed doctor numbers based on population structure, disease patterns, healthcare utilization rates, etc. Second, supply-based projection calculates doctors to be produced considering current medical school enrollment, license holders, retirement rates, etc. Third, both are compared to predict shortage or surplus scale.
  • Doctor supply projection can vary greatly depending on variable settings, leaving room for controversy. Issues include how to predict healthcare demand, how to reflect efficiency improvements from medical technology advances, and how to consider changes in doctors' work scope. The government predicted 10,000 doctor shortage by 2035, but the medical community argues methodology is weak and overestimated. Transparent methodology disclosure and expert verification are essential for reliable projections.

🔎 Mandatory Service System

• Mandatory service system requires working at designated places for set period as repayment for benefits.
  • Mandatory service system refers to system where people who received tuition, training costs, etc. from state or institutions must work at designated places for set period as repayment. In medical field, representative examples include public health doctors, military doctors, and Regional Doctor System.
  • Regional Doctor System mandatory service conditions include: First, service period is determined proportional to years of scholarship support received during school years. Generally around 10 years service after 6 years of study is expected. Second, service regions are designated as public hospitals, health centers, etc. in medically underserved areas. Third, service fields are assigned from regional and essential healthcare. Fourth, if obligation is not fulfilled, scholarship must be repaid with interest.
  • Mandatory service system's advantage is ensuring workforce deployment in fields needed by the state. Students can also graduate from medical school without financial burden. However, limitations exist in not guaranteeing regional settlement after service period and restricting individual career choice. To increase effectiveness, settlement support after service and regional healthcare environment improvement must accompany.

5️⃣ Frequently Asked Questions (FAQ)

Q: What benefits do students receive if selected for the Regional Doctor System?

A: Students receive full tuition and living expenses during their studies, graduating from medical school without financial burden.

• Students selected for the Regional Doctor System receive full tuition support for 6 years from admission to graduation. Additionally, living expenses, textbook costs, and dormitory fees are supported to a certain level, greatly reducing financial burden. Support scale varies by university and local government, but typically amounts to tens of millions to over 100 million won over 6 years.
• However, these benefits are exchanged for mandatory service conditions after graduation. After obtaining medical license, students must work in designated medically underserved areas or essential medical fields for typically around 10 years. If obligation is not fulfilled, all received scholarship must be repaid with interest, so careful choice is needed. This system is suitable for students with firm commitment to regional healthcare and long-term career plans.

Q: Where and what work is done during mandatory service period?

A: Work involves treating regional residents and essential medical duties at public hospitals or health centers in medically underserved areas.

• Mandatory service regions are assigned from government-designated medically underserved areas, mainly public hospitals, health centers, and health substations in farming, fishing, mountain, and island villages. Service fields are determined according to regional needs from primary care for regional residents, emergency medicine, and essential healthcare like obstetrics and pediatrics. For example, providing childbirth services in regions without obstetrics, or serving emergency duty in regions lacking emergency rooms.
• Service period is generally expected around 10 years, but specific duration may vary depending on system design. During service period, doctors work as civil servants or public medical institution staff and receive salary and welfare benefits. However, working conditions may be poorer compared to major city large hospitals, and accessing latest medical technology may be difficult. The government promises treatment improvement and training opportunities for service doctors, but actual implementation remains a future task.

Q: Can career be freely chosen after mandatory service ends?

A: Legally career can be freely chosen after mandatory service period ends, but system's purpose is encouraging regional settlement.

• After completing full mandatory service period, there is no further legal obligation, so moving to major cities, opening practice, or entering other fields is possible. However, system's original purpose is encouraging doctors to take root in regions during mandatory service and continue settling even after service. Working in one region for 10 years is expected to form bonds with regional residents and establish position in hospitals, increasing settlement possibility.
• However, concerns exist that many may leave for major cities after merely completing service period. This is because settlement incentives are insufficient without improved regional living conditions, children's educational environment, and spouse employment. The government is reviewing various incentives to encourage settlement after service, including hospital opening fund support, housing purchase assistance, and children's education expense support. Additionally, improving regional healthcare infrastructure to create environments where doctors feel rewarded and want to continue working is important.

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