Ethics lacking in Korea’s medical student selection process

Two years ago, I met with Canadian doctors while reporting on the problem of emergency patients being transferred between hospitals. The number of doctors per 1,000 people is similar, 2.8 in Canada and 2.6 in South Korea. Yet in Canada, it is rare for critically ill patients to be shuffled from one hospital to another. Surgeons are not pulled away to cosmetic procedures, leaving operating rooms empty. I wanted to understand how this was possible.

“Is it because cosmetic procedures don’t pay well in Canada?” I asked.

“No, they earn a lot. Why?”

A brief silence followed as we exchanged puzzled glances. Scott Banks, a professor of emergency medicine at the University of Calgary, explained, “If most doctors choose only the profitable specialties, it reflects a failure in selecting medical students.” He then asked, “In Korea, do you focus solely on grades? Don’t you consider why someone wants to become a doctor?” It was a question I had never encountered before.

To be clear, this is not meant to criticize medical students. They have already chosen a challenging path. Yet society has a responsibility to provide proper guidance. Admissions processes offer an early glimpse into professional ethics. If exams focus only on memory and speed, those are the only abilities that develop. Asking, “Why did you choose this path, and whom will you serve?” cultivates different capacities, what William Osler, the father of modern medicine, described as the ability to “treat the patient beyond the disease.”

Medical schools in Canada, the U.S., and the U.K. are structured so that no matter how excellent a student’s grades are, they cannot be admitted without volunteer work and community experience. Many Canadian schools place significant weight on the CASPer personality test. Multiple mini-interviews, or MMIs, present questions that cannot be memorized. Students face ethical dilemmas such as, “Who would you treat first if there are too few hands?” or “How would you persuade a patient who refuses treatment?” to evaluate their underlying philosophy. At the University of Montreal, 40 percent of the initial selection is based on the personality test, and the final stage is entirely MMIs.

In contrast, South Korean medical schools focus primarily on grades. Interviews exist, but candidates generally prepare by memorizing answers. It is difficult to properly assess social responsibility. Interviews typically account for only 5 to 20 percent of the selection process, making them largely symbolic.

Seoul National University’s College of Medicine recently announced a curriculum reform aimed at addressing these concerns. Beginning in the first semester of 2027, new courses such as “team sports” and “community medical practice” will be introduced to foster empathy, inclusivity, and a sense of sacrifice. “Through conflicts in medical policy, we realized the need for education that goes beyond knowledge transfer," Dean Kim Jeong-eun said at an interview. "We aim to instill an awareness that doctors must give back to society the benefits and privileges they have received.”

Seoul National University’s reforms are only a starting point. It is now time to reconsider the criteria for selecting medical students. Many people have been deeply disappointed not only by policy confusion but also by doctors leaving patients behind during healthcare disputes. Shouldn’t candidates be asked at the selection stage whether they are ready to dedicate themselves to patients and society?

Those who answer this question for themselves walk a different path, even with the same knowledge. As more doctors carry this answer with them on their white coats, the wounds from healthcare conflicts may finally begin to heal.