Concerns are mounting that requiring doctors to work in specific regions -- and penalizing those who leave early -- may not improve access to care in underserved areas and could instead increase social conflict.
Experts say Korea should learn from Japan and Taiwan, where similar policies have had limited success.
Kim Gye-hyun, a research fellow at the Healthcare Policy Research Institute, speaks during a seminar Tuesday. (KBR photo)
Kim Gye-hyun, a research fellow at the Healthcare Policy Research Institute under the Korean Medical Association, raised the issue during the “2026 Joint Health Policy Seminar” held Tuesday at the National Assembly Members’ Office Building.
The seminar, themed “The Answer to Policy Lies in the Field: The Crisis of Regional Healthcare and the Regional Doctor System,” reviewed international physician allocation systems. It was co-hosted by lawmakers So Byung-hoon, Lee Su-jin, Kim Yoon, and Seo Mi-hwa of the National Assembly’s Health and Welfare Committee.
According to the institute, as of 2020, 18.2 percent of Japan’s medical school admissions quota was allocated to regional tracks. Under the system, local governments select and financially support students on the condition that they work in designated regions and specialties for nine to 11 years after graduation. Some municipalities have imposed repayment obligations and additional penalties on those who leave early.
There have also been reports that doctors under mandatory service faced workplace discrimination or harassment but were reluctant to speak out due to contractual obligations.
The system’s effectiveness has also come under scrutiny. A survey by Japan’s Ministry of Health, Labour and Welfare for 2019–2020 found that 4.6 percent of graduates from regional tracks left their assigned areas. Separate surveys of clinical trainees since 2017 show more than 10 percent consistently expressing intent to leave.
“About 70 percent of physicians selected through regional quotas remain in their assigned areas, but only around 30 percent stay in truly underserved regions,” Kim said.
Despite regulatory tightening -- including reduced subsidies for institutions hiring early leavers and restrictions on specialist certification -- critics say these measures have not addressed structural imbalances.
“In lawsuits filed by early leavers, courts have ruled that such penalties are unjust, citing restrictions on career choice,” Kim said. “A government review panel concluded that physician maldistribution remains unresolved even after two decades.”
Taiwan’s publicly funded medical student program, introduced in 1969, shows similar patterns. According to Taiwan’s Ministry of Health and Welfare, only 18 percent of participants were working in underserved areas as of 2018. Dropouts and transfers to general admission tracks have increased, alongside growing legal and social challenges to the system.
“Coercive measures in Japan and Taiwan had limited impact and triggered social conflict,” Kim said. “Korea may face similar challenges if it adopts comparable policies.”
Koh Jung Min
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