Abstract
Editor,
We read with interest Vaughan and McKee’s discussion of how expanding medical school places under financial constraints and limited supervisory capacity may affect the scientific depth and professional identity of undergraduate medical education. 1 South Korea currently faces a parallel risk as it pursues physician expansion primarily through admissions numbers.
In 2023, 28% of doctors were located in Seoul, the capital of South Korea, where physician density was more than double that of some provinces. 2 Furthermore, physicians have favoured elective services (e.g. cosmetic dermatology) that sit largely outside National Health Insurance coverage, and this reinforced both geographic and specialty maldistribution. To address this, on 10 February 2026, the government announced a phased increase in medical school admissions for 2027–2031, adding 3342 places (an average of 668 per year). All additional seats will be assigned to medical schools outside Seoul under a ‘regional doctor’ track with an approximately 10-year service obligation in designated provinces. 2
While this approach may increase the number of physicians outside of Seoul, three issues merit attention. First, if remuneration and medicolegal risk remain less favourable in essential specialties and in regional hospitals, graduates may continue to prefer elective and metropolitan practice, particularly after service obligations end. Second, rapid intake growth may test training infrastructure in some regional schools, including faculty numbers, clinical placements and teaching‑hospital capacity; transparent quality assurance and sustained investment in supervision may therefore warrant consideration. Third, as digital tools and AI increasingly shape patient care, workforce projections may benefit from regular revisions that incorporate plausible productivity and task-allocation changes rather than assuming current practice patterns will persist unchanged. 3
Admission expansion is likely to be more credible when it proceeds in step with training capacity and is paired with payment, medicolegal and staffing reforms that make essential regional practice sustainable.
