Education Story

What medical school rankings and dropouts from regional medical schools tell us

Education policy is not confined to the classroom and examination hall. Even if enrollment quotas are increased, the proportion of local talent is raised, and the weight of regular admissions is adjusted, the effects immediately fall upon the socioeconomic landscape of household assets, the private education market, the dual structure of the labor market, and concentration in the Seoul metropolitan area. The distortion of university admissions in Korea, the over-concentration in medical schools, the dropout rate from regional medical schools, and the phenomenon of those dropouts moving towards medical schools in Seoul and the metropolitan area are vivid examples of this very premise.

In 2025, 383 students dropped out of 39 medical schools nationwide. This is almost the same as the 386 students in the previous year, and more than double the 178 students in 2022, before the expansion of enrollment quotas. Of these, 301 students, or 78.6%, were from regional medical schools. Only 48 were from Seoul-area schools and 34 from Gyeongin-area schools. By university, Kangwon National University had 22, Wonkwang University 18, and Gyeongsang National University and Dankook University Cheonan each had 17, showing that the top ranks are concentrated in regional medical schools, while Seoul National University, Korea University, Ewha Womans University, and Konyang University each had only 2. By region, Busan-Ulsan-Gyeongnam had 67, Chungcheong 66, Daegu-Gyeongbuk 56, and Gangwon 51. The interpretation repeatedly pointed out by the admissions industry is relatively simple: a path is operating where students first enter a regional medical school, then retake the Suneung (CSAT) to 'transfer' to a medical school in the Seoul metropolitan area or a higher-ranked one.

These numbers are not a matter of individual caprice, but a product of structure.

The core problem with Korea's college entrance exam system is not the 'fairness of selection' but 'what selection allocates socially.' The Suneung (College Scholastic Ability Test) and internal school grades, as well as early admission (Susi) and regular admission (Jeongsi), are not only tools for measuring ability but also for distributing positional goods. Because the hierarchy between universities and departments ties into lifelong income, job stability, the marriage market, and symbolic capital, a single point or grade difference becomes the entirety of a household's strategy. The rule mandating 40% regular admission for major Seoul universities, introduced after the Cho Kuk scandal, was a policy aimed at reducing the 'unfairness of spec competition,' but in reality, it tilted towards institutionally rewarding households favorable to N-th attempts and private education, i.e., households with high parental socioeconomic status. The analysis that the proportion of children from higher income brackets who take a gap year or retake the exam is about three times higher than those from lower brackets shows that while the expansion of regular admission outwardly strengthens meritocracy, it inwardly selects for economic endurance.

The concentration on medical schools is at the apex of this structure. After the IMF crisis, as the labor market split into regular and non-regular jobs, and entry into large corporations and the public sector narrowed, the value of 'professions that prevent downward mobility with a license' skyrocketed. Doctors virtually have no retirement age, can switch between private practice and salaried positions, and have a thicker income floor than other specialized professions. For young people, medical school is not an academic pursuit but an asset that insures against life risks all at once. The phenomenon of top-tier science students flocking to medical schools instead of semiconductors, AI, or basic science is not individual greed, but a signal that society cannot provide the same level of compensation and stability to STEM fields as it does to doctors. The fact that private education has extended to 'medical school classes' for elementary students and the age of entry into the labor market is pushed to around 30 is the social cost of that signal.

Here, regional hierarchies overlap. In Korea, medical schools are not a single 'institution for training doctors.' Medical schools in the Seoul metropolitan area, including Seoul National University, Yonsei University, and Korea University, and those affiliated with the so-called 'Big 5' hospital network, differ from regional national university medical schools and other private regional medical schools not only in admission scores but also in training hospitals, resident assignments, clinic locations, and the symbolic value of marriage and networks. In a society where 'which medical school you graduated from' matters even with the same medical license, admission to a regional medical school becomes a way station rather than a final destination. As the regional talent admission system expanded and the 2025 enrollment quota temporarily increased, top-tier students in regional areas reasonably adopted a strategy of first entering a regional medical school to secure a license track, then moving up to the Seoul metropolitan area. The policy aimed to increase the number of doctors in regional areas, but families used that policy as a stepping stone to enter the Seoul metropolitan area.

The main reason for the high dropout rate from regional medical schools is not academic maladjustment. Of course, there are also failures, academic warnings, and mismatches in aptitude. However, the pattern of a sharp increase in dropouts in 2024-2025 coinciding with the expansion of enrollment, the overwhelming concentration of dropouts in regional areas compared to Seoul and Gyeongin, and the almost non-existent dropout rate in top-tier medical schools like Seoul National University and Korea University, points more to 'reallocation' than 'maladjustment.' Dropping out is not a record of failure, but rather a payment of cost to move to a higher status good. Students with the time, academy fees, and family financial buffer needed for re-application or re-taking exams are more able to bear that cost. This is where the paradox arises that admission to a regional medical school actually becomes a safety net for multiple attempts. Students who entered through the regional talent system are more likely to challenge themselves again with the psychological assurance that 'I've already secured a medical school spot.' The more the policy expands regional quotas, the more those quotas become a waiting list for re-entry into the Seoul metropolitan area.

The meaning of these students aiming for medical schools in Seoul again is not 'a better school.'

Sociologically, three layers overlap here.

First, the stratification of space. Seoul is not only a place where jobs, hospitals, and information are concentrated, but also a stage where a 'normal, upper-class life' is envisioned in Korean society. Considering the already high rate of medical school graduates from provincial areas moving to hospitals in the Seoul metropolitan area, the movement to secure a spot in Seoul from the admission stage has simply brought forward the post-graduation migration to pre-admission. The hierarchy of medical schools is not a matter of medical personnel distribution but a mechanism that reproduces the hierarchy of national territory.

Second, the exchange of cultural capital and economic capital. In the words of French sociologist Pierre Bourdieu (1930–2002), CSAT scores and medical school prestige are academic capital, and the time, money, and information of households that can repeatedly acquire them are economic capital and social capital. Admission to a provincial medical school is a process of first securing academic capital, and then using the household's surplus capital to purchase higher academic capital. Therefore, the statement 'provincial medical students go to Seoul medical schools' is not 'more capable students move,' but rather 'classes that can afford the moving costs move.'

Third, policy capture. Quota expansion, 60% regional talent, and the upcoming regional doctor system are all policies aimed at filling the medical void in provincial areas. However, if mandatory service and scholarships cannot offset individuals' desire for upward mobility and the premium of the Seoul metropolitan area labor market, the policies will be circumvented. If the 2027 regional doctor system attracts more graduates from provincial high schools, the number of provincial medical school entrants will increase in the short term. At the same time, the incentive for some of these entrants to re-challenge for admission to the Seoul metropolitan area through general admission or regular admission could also increase. If policies do not directly address class and regional hierarchies, they become fuel for those hierarchies.

As long as the college entrance examination system is designed solely as a 'fair ranking,' this cycle will repeat. The Suneung (CSAT) appears objective, but it is already stratified by the length of preparation time and the intensity of private education. The early admission system (Susi) exploits the disparities between schools and consulting services, and the regional talent quota becomes a safe exit for the upper class within the region. Policies that only adjust the number of medical school admissions can increase supply, but they cannot eliminate the question, 'Which medical school is the gateway to the upper echelons of society?' As long as that question remains, classrooms in regional medical schools will be empty, and waiting lists for Seoul medical schools will grow longer.

Ultimately, what the Korean college entrance system and the overconcentration on medical schools reveal is not a failure of education, but the narrowness of the social contract. Because a stable life, respected professionalism, and a status that can be passed down to children are excessively concentrated in a single medical license, education becomes an auction house centered around that license. The reason why changes in education policy do not extend beyond socioeconomics is that education is already the most sensitive distribution mechanism of that socioeconomy. The fact that eight out of ten dropouts from regional medical schools come from regional areas, and that they once again look towards Seoul, is not a matter of individual desire, but an indicator of how narrow and concentrated the safe paths allowed to young people in Korean society are.