Legal education reform and medical litigation: Improved access but delayed justice in plastic surgery malpractice cases in South Korea

South Korea's 2009 legal education reform, which replaced the bar exam and two-year judicial training system with graduate-level law schools, aimed to enhance the quality and accessibility of legal services. This study examines its impact on malpractice litigation in plastic and reconstructive surgeries and procedures (PRSP). Using publicly available civil court decisions, we conducted a retrospective analysis comparing litigation patterns before (2006-2012, n = 23) and after (2017-2021, n = 75) the reform, excluding the transitional period (2013-2017). Our findings reveal significant increases in litigation frequency (3.28 to 15 cases annually, p < 0.001) and case duration (median: 969-1,570 days, p < 0.001). While the increased litigation frequency and reduced adjudicated damages (median reduction: 75.8%) suggest improved accessibility to legal services - aligning with reform objectives - prolonged case durations highlight unresolved systemic challenges. The transition from practical training to academic-focused legal education, coupled with limited expansion of judicial infrastructure, has contributed to procedural delays despite consistent judicial standards in malpractice assessments. These findings underscore the dual impacts of the reform, achieving partial success in improving access to legal representation but exposing inefficiencies in judicial capacity. To address these challenges, short-term measures such as appointing additional judges and establishing specialized court divisions are needed. In the mid-term, implementing AI-based case management systems could enhance procedural efficiency. Long-term strategies, including structured mediation programs, are critical to alleviating court burdens and ensuring timely resolutions.