Selection policy necessary

THE University of Otago should be heartened by the response to nowabandoned talk of capping how many students it accepts into medicine using its Mirror on Society selection policy.

That so many people demanded caps be rejected well before they were formally proposed says the university is right to be proud of a policy that is gradually addressing inequity.

The eightyearold policy underpins preferential entry programmes that affirm the university’s position that graduating cohorts should reflect the communities they are trained to serve.

The policy identifies Maori, indigenous Pacific, rural, low socioeconomic and refugee groups as eligible for consideration for entry to a raft of Health Sciences programmes.

Figures suggest it has had a significant impact on enrolments and graduates from previously underrepresented groups. Maori students were last year 12.4% of students in health science undergraduate professional degrees. They were 9% in 2015.

On average, 38 Maori doctors graduated each year from 2016, compared with an average of 14 between 2010 and 2015.

Work published in the New Zealand Medical Journal found the policy helped increase sociodemographic diversity and that this might be good for society as a whole.

The study noted international evidence showed health workforce diversity leads to better outcomes in diverse populations. There was also evidence students’ backgrounds influenced where, and in which communities, they practiced.

It follows that affirmative pathways are a tool to train a workforce that better reflects the many different markets in which it must operate. It recognises one size, no matter how well trained, does not fit all.

This was among the entirely justifiable arguments pitched when the academic community was blindsided by a discussion document that referred to capping some admissions.

That the policy was up for review was no secret — it was due for another look in January next year — but that preamble talks would raise cutting it back was entirely unexpected.

Talk of capping the asyet uncapped Maori Entry Pathway was quickly explained away as a necessary discussion point rather than a firm proposal to change the rules.

The review was just that — a review — and nothing would progress without formal consultation.

The university made it clear it was proud of its policy, and was committed to it.

Even so, many people are wary of any tinkering that might devalue the policy. Doctors are worrying on closed social media pages and open letters urge a firm no to any caps.

In many respects, this is a sure sign those who ought to know support the university’s broad aims to improve the gross underrepresentation of some groups in the workforce.

Theirs is a challenge to keep going, but the university faces a challenge to modify the programme to such an extent its aims will be rendered piecemeal.

A challenge in the High Court is likely to argue the university’s policy should only admit people at a rate relative to their group’s proportion of the total population. The university will argue this will slow the rate at which a representative workforce can be achieved.

The court may hear Maori were more than 16% of the population and 3.5% of doctors in 2018. Pacifika were roughly 8% of the population and 1.8% of doctors in 2018.

The New Zealand Medical Workforce 2018 report says there would be be 2410 Maori doctors and 1082 Pasifika doctors if the workforce were to reflect the makeup of New Zealand’s population. There were an estimated 573 Maori and 295 Pasifika doctors at the time.

Clearly, proportionality is an issue that must be addressed. Capping numbers is clearly not an answer when the question ought to be ‘‘can we improve diversity, quicker?’’ so that, one day, pathways are not needed at all.