Medical Education Changes: HSS, Digital Shift, Admissions

Educational and organizational changes in training medical professionals

Medical education teaches medical knowledge and clinical skills while helping students understand the systems and collaborative relationships within which they will work as medical professionals. The regional distribution of the health workforce, patient safety, and the use of digital technologies affect both curriculum content and the operation of educational institutions.

Curricula connecting Health Systems Science and clinical settings

The 2023 editorial on Health Systems Science begins with the challenge of adapting the curriculum to a rapidly changing healthcare environment. This context encompasses the syndemic linking the harms of COVID-19 with social inequality, changes in disease patterns and healthcare financing associated with low birth rates and an aging population, and a patient-centered, team-based approach. Acquiring biomedical knowledge and skills does not automatically equip students to understand the healthcare system and the social determinants of health. The core of Health Systems Science education lies in deliberately incorporating systems thinking into the curriculum, enabling students to understand how the various factors affecting healthcare are connected and to make informed judgments.

The conceptual foundation is the framework proposed by the American Medical Association. Its three domains—core, cross-cutting, and linking domains—comprise a total of 12 components. The editorial explains the need for this framework in the context of the introduction of the Affordable Care Act and improvements to the healthcare coverage system in the United States. In discussing the application of Health Systems Science, proposed in 2013, to Korea, the editorial emphasizes the need to adapt it to the Korean healthcare system and culture. Research on education in Korea at the time found no independent course spanning the entire medical school curriculum. The integration of selected content into the existing curriculum is presented as a practical approach. The needs analysis discussed identified high educational needs for the core domains but relatively low needs for healthcare system improvement, quality care, patient safety, and systems thinking.

The proposed educational methods include examining healthcare delivery through cases and posing questions about the healthcare system during clinical clerkships. The editorial discusses how learning professional values and behavioral norms may reinforce conformity to the existing order. Being entrusted to perform clinical skills as supervisors develop confidence in students may also reinforce conformity. Whether faculty members use systems thinking in clinical practice and education is a consideration in curriculum design.

Social accountability and university autonomy in admissions policies

The 2024 editorial on medical school admissions policies connects student selection with social accountability in training the health workforce. According to the editorial, the number of applicants for the medical licensing examination, which previously exceeded 3,000 annually, was 364 for 2025, and 267 applicants passed the clinical skills examination. The editorial projected the number of physicians entering the workforce the following year on the assumption that all of them would pass the written examination. The number of eligible applicants for the medical specialty certification examination was 576, of whom 396 were actively working as residents. Against this background, the editorial discusses including stakeholders such as physicians, faculty members, students, and residents in decisions about admissions policies.

Governance provides the basis for comparing policies. The comparative study discussed explains that Japan shifted from a system in which authority was concentrated in the government in the early 2000s to a collaborative system involving stakeholders from the 2010s onward. Singapore is presented as a case in which universities make policy decisions autonomously and the government plays a supportive role. In South Korea, fairness in selection based on test scores is examined alongside socioeconomic differences in access to preparation. Regional talent quotas and special admissions tracks aim to reduce regional imbalances in the health workforce and increase the diversity of student backgrounds. Interpreting the effects of selecting regional talent also requires attention to the conditions that enable graduates to continue training in the region.

The Southern Illinois University School of Medicine (SIU SOM) was established to address the healthcare needs of southern Illinois. It operates through collaboration between the state government and the regional healthcare system. SIU SOM uses the finding that 34% of its graduates work in primary care as a key performance indicator for the school. The editorial describes criteria that include holistic applicant review, the exclusion of out-of-state residents and foreign nationals from eligibility, and a community service requirement. Applying this selection method in Korea requires consideration of both social expectations for fairness in admissions and institutional differences.

Learning support transformed by digital portfolios and LMS

The 2025 editorial on the digital transformation of medical education connects technology use with changes in learning environments and teaching methods. It distinguishes among digitization, digitalization, and digital transformation, focusing on student-centered adaptive learning and the integration of learning and assessment. The release of ChatGPT in November 2022 and the COVID-19 pandemic are presented as developments that accelerated these changes. The editorial explores the potential of customized learning tools, immersive learning environments, and learning analytics while describing medical schools’ experiences of developing and operating these systems.

The u-Portfolio of Inje University College of Medicine began as a tool for assessing clinical education and expanded into a system supporting students’ academic achievement, growth, and career development. It evolved from a paper-based portfolio into a digital system to manage learning records for students rotating through 5 affiliated hospitals. The u-Portfolio was developed to support student learning in clinical settings through the coordinated design of clinical practice records, faculty assessment and feedback, and assessment rubrics. A consortium of medical schools in Korea was exploring a model that aligned with the accreditation standards of the Korean Institute of Medical Education and Evaluation while reflecting the characteristics of individual university curricula.

At Yonsei University College of Medicine, YES2.0 was upgraded to YES3.0 to reflect CDP2023 (Curriculum Development Project 2023). The cloud-based LMS integrated learning and assessment in real time and strengthened the management of learning data. This represented an attempt to introduce learning analytics into educational administration. Major development tasks included selecting a development agency with an understanding of medical education, analyzing faculty and student requirements, and recording learning process data. Faculty development programs also supported use of the system. The discussion of medical AI education addresses ethical competencies, including detecting algorithmic bias, ensuring data transparency, and protecting patient privacy.

Review and publication supporting student researcher participation

The 2025 editorial on support for student researchers presents a way to incorporate learner perspectives into improvements in medical education. The Korean Medical Education Review, founded in 1999, established the 1st “Korean Medical Education Review Student Researcher Award” in 2025 to support the development of future medical educators. The competition began in January 2025, and manuscripts were accepted until August 15. Of the 9 papers submitted, 2 were rejected for reasons including non-compliance with submission guidelines and incomplete documentation, leaving 7 papers to proceed to review. A panel of 4 experts in medicine, nursing, and education conducted the first and second rounds of review, with the editorial team participating throughout the process.

Evaluation criteria included the appropriateness of the research topic, the validity of the methodology, the appropriateness of the methods used to derive and interpret results, academic contribution, and structure and completeness. After 2 papers were excluded in the first round of review, 5 underwent evaluation. The combined review scores determined the recipients of one Grand Prize, one Excellence Award, and one Encouragement Award. The 2 papers that did not receive awards were also published alongside the winning papers in recognition of their academic value and completeness.

A systematic literature review on the psychological impact of learning loss among medical students used the PROMIS (Patient-Reported Outcomes Measurement Information System) framework. A systematic literature review on medical humanities education in Korea organized learning outcomes using the Kirkpatrick model. An interprofessional education (IPE) study in nursing combined a comparison of domestic and international implementation with a survey of nursing students’ needs and perceptions. A teamwork study of graduate students participating in an international medicine program used a qualitative approach to explore psychological safety, multidisciplinary role coordination, and application in the field. A spiritual nursing study examined nursing students’ perceptions and educational needs through a mixed-methods approach.

Higher education in the AI era and relational learning

The 2026 commentary on the future of higher education proposes a conceptual framework for understanding the growth of knowledge, the spread of AI, and an uncertain social environment. VUCA refers to volatility, uncertainty, complexity, and ambiguity. It connects education with problems that lack predetermined answers, such as climate change and responses to infectious diseases. The commentary cites existing estimates of the doubling time of medical knowledge, tracing a change from approximately 50 years in 1950 to 7 years in 1980 and 3.5 years in 2010, alongside an estimate of about 73 days. It also cites the EDUCAUSE 2024 AI Landscape Study, which reports that 86% of students use AI tools for their studies. These figures support the inclusion of information evaluation and use as educational goals.

Research on AI image generation addresses bias in training data through a case in which a system failed to generate an image of a Black African physician treating a white child despite over 300 attempts. Informal replication attempts described in the commentary succeeded in generating such an image. This prompted a distinction between rapid system updates and structural bias. The commentary emphasizes experience in assessing AI’s biases and limitations and considering diverse perspectives through community dialogue. Communities of practice are presented as settings in which professional ethics and identity develop through discussion of norms and learning through action.

The evidence supporting the role of relationships draws on health and medical research as well as educational theory. The commentary cites an analysis of 90 cohort studies on social isolation and loneliness. An analysis of 734,889 cancer patients reported a 20% lower risk of cancer mortality among married individuals. A meta-analysis of 87 studies associated perceived social support with a 25% reduction in mortality risk. Connecting research on health and mortality risk to education requires consideration of each study’s participants and measures of relationships, alongside a separate examination of how participation, feedback, and a sense of belonging in educational settings relate to learning.

Reading notes

Examining the outcomes of the u-Portfolio requires considering both its introduction and changes in how faculty provide feedback based on learning records. Learning activities recorded in the LMS and actual feedback experiences can help specify research questions for each educational objective. HRD research can explore how individual competencies develop within a context of organizational support by connecting faculty development, practices for giving and receiving feedback in the workplace, and student participation in research.

References

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안신기. (2024). 대한민국 의과대학 입학제도는 어디로 갈 것인가? 의학교육논단, 26(3), 171–173. https://doi.org/10.17496/kmer.24.036

안신기. (2025). 의학교육의 디지털 전환: 도전과 기회. 의학교육논단, 27(1), 3–5. https://doi.org/10.17496/kmer.25.004

안신기. (2025). 학생 연구자의 첫걸음이 의학교육의 내일이 되기를. 의학교육논단, 27(Suppl 1), S1–S2. https://doi.org/10.17496/kmer.25.042

An, S. (2026). Navigating the future of higher education: Embracing change while preserving the relational core of learning. IGEE Proceedings, 3(1), 1–8. https://doi.org/10.69841/igee.2026.006