Medical brain drain: A crisis in the making

Since February 2024, 99% of medical students in South Korea have been boycotting medical school after the government announced a 65% increase in medical school places. Last month, it announced it would halt its plans to increase admissions quotas if all students returned to class.

But this olive branch is likely too little, too late. Thus far, the Korean Medical Student Association, which represents students from 40 medical schools, is maintaining its stance that students should continue their protest through a leave of absence. Nevertheless, some institutions are reporting that nearly all medical students have submitted applications to resume their studies. More clarity will likely be available by June when the medical school academic year starts in South Korea.

Why students are protesting

There are many reasons underlying the student protests; the increase in medical school places was merely the catalyst. The government warns of a looming doctor shortage, projecting a deficit of 15,000 physicians by 2035 due to an ageing population and low doctor-to-patient ratios compared to other OECD countries.

However, students and doctors challenge these figures, arguing that Korea has enough physicians and that the real issue lies in systemic failures. Their concerns focus on the National Health Insurance Service (NHIS), doctors’ risk of criminal prosecution and the quality of medical education. They are frustrated with the government’s plan to merely flood the system with more physicians without addressing the root problems.

Doctors in Korea are only permitted to work under the state-controlled NHIS, which sets fees for insurance-covered services at levels often below the actual costs incurred by providers. As a result, hospitals have been forced to rely on out-of-pocket services (many of which may be unnecessary) to remain financially viable.

Doctors, who should be free to make clinical decisions based solely on patient needs, are instead pressured to prioritise volume-driven care to offset financial losses. Students are calling for reforms to ensure healthcare pricing reflects true costs.

While the Korean government and medical professionals debate the overall doctor shortage, both sides acknowledge a critical gap in essential specialties such as emergency medicine, obstetrics and paediatrics. These fields see few recruits, as doctors face a significant risk of criminal prosecution due to the large volume of higher-risk procedures.

Unlike most countries, where medical malpractice is handled under civil law, Korea sees an average of 754.8 doctors facing criminal prosecution every year. Confronted with this legal threat, Korea’s medical students are calling for greater professional protection.

Another reason for the protests is the argument that expanding medical school enrolment by 65% with just a year’s notice risks compromising the quality of education. Medical training depends not only on lectures but also on hands-on clinical experience, hospital-based teaching and small-group discussions, all of which could be compromised by a sudden surge in student numbers.

Without adequate preparation and investment, such rapid expansion threatens to undermine medical educational standards.

Brain drain

The South Korean healthcare system must now also confront the risk of ‘brain drain’. Korea’s best and brightest medical students and doctors are now looking abroad, with the percentage of students favouring overseas residency training rising to over 40%. Korea risks losing a cohort of medical professionals and researchers to countries such as the United States, United Kingdom and Germany.

This brings South Korea to a pivotal crossroads. Currently, South Korea boasts an affordable and accessible healthcare system and is home to three hospitals ranked in the top 20 in Newsweek’s 100 Best Specialised Hospitals across multiple specialties.

At the same time, the country is facing an escalating workforce crisis with no simple solution in sight. Also, 90% of resident physicians have resigned in protest of the medical school quota announcement, and only 2.2% of these doctors have reapplied for residency training for the 2025 academic year. The global hospital rankings, while a testament to past achievements, could soon become relics of a bygone era unless South Korea can address its students’ exodus and inspire them to stay.

For international students to pursue medical residency in the US, they must hold a medical degree, pass Step 1 and Step 2 of the United States Medical Licensing Examination (USMLE) and secure a training position. Many Korean doctors and students have already completed these exams, and YouTube channels offering advice to Koreans applying for US residency programmes have amassed hundreds of thousands of views.

Recent political developments in the US – including Trump’s tariffs and America first policies – and in South Korea – including the impeachment of president Yoon Suk Yeol – are unlikely to change anything, particularly given that doctors in the US earn considerably more than in many other countries.

Shifts in medical specialty preferences raise further concerns. Interest in essential medical specialties has plummeted to just 19%. South Korea already has massive vacancies in many of the essential medical specialities, most acutely in rural areas. If these trends continue, the country may face an unprecedented workforce crisis, with too few doctors in critical fields to meet the needs of an ageing population.

For the past 13 months, medical students have redirected their time toward alternative pursuits, from conducting research to exploring hobbies and completing clinical observerships abroad.

These experiences broaden their perspectives and enhance their competitiveness for residency programmes overseas, positioning them as strong candidates in an increasingly globalised medical landscape. Even if students return to medical school in 2025, many may only stay long enough to earn their degrees before seeking opportunities abroad.

Without decisive action to address the concerns of its doctors and medical students, South Korea risks the decline of its world-class healthcare system and the loss of its future medical leaders to a globalised market eager to embrace their talent.

Anna de Beer is a medical student at Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom. E-mail: annadebeer@gmail.com

This article is a commentary. Commentary articles are the opinion of the authors and do not necessarily reflect the views of University World News.