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. 2025 Oct 10;25(1):1399.
doi: 10.1186/s12909-025-07998-8.

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

Yoonjung Lee  1   2 , Jwa-Seop Shin  1   2 , Wan Beom Park  3 , Hyun Bae Yoon  4   5
Affiliations

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

Yoonjung Lee et al. BMC Med Educ. .

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.

Keywords: 6-year continuous medical curriculum; Competency-based medical education; Curriculum reform; South korea; Stakeholder engagement.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was reviewed and approved as exempt by the Institutional Review Board of *** University College of Medicine and Seoul University Hospital (IRB No. E-2306-144-1441), as it involved the analysis of anonymized, non-identifiable data and posed minimal risk to participants. Written informed consent was not required in accordance with institutional guidelines and IRB determination. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Average distribution of phases during the total 6-year curriculum
Fig. 2
Fig. 2
Average distribution of themes by year
See this image and copyright information in PMC

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