Breaking the mould: stakeholder insights into the shift from 2 + 4 to a 6-Year continuous medical curriculum in South Korea.

Abstract

Background: In response to global reforms emphasizing competency-based learning and integrated curricula, South Korea is transitioning from its traditional 2 + 4 medical education model to a 6-year continuous medical curriculum. This shift addresses challenges such as fragmented learning pathways and insufficient integration between foundational and clinical training, which have limited the development of professional competencies and holistic student engagement. However, empirical evidence on stakeholder perspectives regarding this transition remains limited. This study aimed to examine faculty and student views on the proposed reform to inform its implementation and contribute to broader discussions on medical education transformation.

Methods: A mixed-method study was conducted at Seoul National University College of Medicine. Quantitative data were collected from an online survey completed by 142 faculty members and 133 medical students. Qualitative data were gathered from two focus group interviews with fifteen students from both pre-medical and clinical phases. Survey responses were analyzed using Welch's t-tests, and thematic analysis was applied to focus group interview data.

Results: Quantitative analysis revealed significant differences between faculty and student perceptions of the proposed 6-year continuous medical curriculum. Faculty reported higher scores for perceived needs (M = 4.05 vs. 2.79, p < .001), continuity, motivation, and curriculum supplementation (all p < .01). Students expressed greater concerns about curriculum overcrowding, academic burden, reduced interdisciplinary learning, and stress (all p < .01), and prioritized vacation time (M = 4.39 vs. 3.82, p < .01), extracurricular support (M = 4.14 vs. 3.52, p < .01), and pass/fail grading (M = 4.09 vs. 3.36, p < .01). Faculty emphasized integration of spiral and repetitive curriculum (M = 3.55 vs. 3.49, p = .02) and new content such as data science and health systems science (all p < .01). Thematic analysis identified student expectations for early integration of clinical and foundational subjects, balanced workload, and structured support systems, alongside concerns about marginalization of the pre-medical phase and prolonged stress.

Conclusion: The transition to a 6-year continuous medical curriculum requires a comprehensive approach that engages key stakeholders, particularly students. Balancing educational innovation with curriculum manageability and student well-being is essential. Participatory design, phased implementation, and robust support systems are needed to ensure sustainable and adaptive curriculum reform.