The planned introduction of a new program to train specialist doctors has been postponed for a year over concerns it will lead to a concentration of doctors in urban centers at the expense of rural areas. The parties concerned, including the government, universities, hospitals and medical professionals, should rethink the program to make sure it meets the medical needs of the nation's citizens no matter where they live.
It will be vital to avoid repeating the policy mistake made in 2004 in connection with the system for training doctors. From that year the government made two years of clinical training mandatory instead of voluntary, and university medical schools and hospitals attached to university hospitals were no longer the sole providers of clinical training. Doctors were allowed to choose where to go, and many chose to do their clinical training at private hospitals in big cities, where they could learn more practical medical skills and receive better pay than at university hospitals.
This caused a serious shortage of doctors at university hospitals — which then served as a physician pool — and prompted them to stop dispatching experienced doctors to other hospitals. As a result, hospitals outside of urban centers experienced a doctor shortage, and in the worst cases were forced to shut down some departments. The policy wreaked havoc on medical services in rural areas, which had already been impacted by the closure of some public medical institutions amid the wave of municipal mergers that stared in the mid-1990s.