의과대학 정원 증원에 관한 학술적 논의와 고찰 = Literature Review and Discussion on the Medical School Capacity Expansion in South Korea

다국어 초록 (Multilingual Abstract)

This article discusses the policy initiative to significantly expand the number of medical school seats, which has triggered serious conflicts in South Korea. As a response to this issue, the paper reviews international academic literature on the appropriate supply of physicians and examines the impact of increasing physician numbers on healthcare quality and health outcomes, drawing key implications. The general conclusion of overseas studies is that expanding the physician workforce has not resulted in a proportional distribution of physicians across geographic regions and specialties. Physicians remain concentrated in urban and affluent areas, while medical students tend to pursue specialties that offer higher incomes and lower risks. Therefore, the distribution of physicians across regions and pecialties is as important as the overall increase in physician numbers. The appropriate scale of expansion should take into account physician roductivity, models of service delivery, and the complementary or ubstitutive roles of other healthcare professionals. Given South Korea’s market-oriented healthcare system, simply increasing the number of physicians is likely to drive up healthcare expenditures without yielding proportional improvements in health outcomes. Therefore, we propose a gradual adjustment of medical school admissions, prioritizing additional enrollment in institutions that focus on essential medical specialties and primary care, or that enhance training in underserved areas. To encourage specialization in critical care, we recommend shifting the basis for calculating fees in the Relative Value Scale system from cost-based to value-based pricing. To mitigate concerns around medical malpractice, we propose the introduction of a mandatory medical malpractice insurance scheme. The expansion of the physician workforce should be accompanied by complementary measures, including regulation of the supply and utilization of healthcare services, stronger institutional oversight of both national health insurance (NHI) and private health insurance, and the reinforcement of ethical standards among physicians—especially to address rising costs and imbalanced distribution across regions and specialties. In particular, there should be regulatory controls on the overutilization of elective procedures, non-essential and non-emergency care, and services not covered by NHI.