Maori doctors are graduating at a rate greater than ever before. This is quite miraculous. The secondary education system fails to produce a proportionate number of Maori with excellent Level 3 NCEA qualifications in the science subjects required for successful medical study.
After significant investment and comprehensive initiatives, there are currently 373 Maori medical students studying at Otago and Auckland. Between us we graduated 79 in 2016. So the Maori medical workforce is young and rapidly growing.
What we don’t have is a pool of appropriate Maori graduates waiting around for another medical school to open.
The University of Waikato has proposed a third medical school with a focus on producing graduates for provincial New Zealand. Waikato states in its business case that it “represents an opportunity to engage higher proportions of Maori students in medical training and to focus them on returning to provide primary care in their communities”.
Maori graduates who want a career in medicine already apply to our programmes. If they have a strong degree with good marks, they are usually accepted. We also provide alternative pathways for those who need additional support. It is at best naïve to think medical programmes at Auckland and Otago, with leadership from their senior Maori medical academics, have not given full consideration to this group of potential applicants.
The Waikato proposal will simply transplant the same Maori applicants from Auckland and Otago into a programme focused on general practice. Yes, meeting the medical needs of rural communities is a priority. However, I object to the idea that Maori should be trained solely for careers in general practice.
Maori doctors are needed in every speciality. Training Maori doctors only to work in areas where others don’t want to work is discrimination.
We need Maori doctors to wake up every morning passionate about going to work. During medical school and as junior doctors, our early ideas of possible specialisation develop. With our careers lasting about 40 years after graduation, it’s important for both career satisfaction and patient outcomes that Maori doctors are in a specialisation of their choice.
The existing medical programmes already deliver the full scope of clinical specialisations, alongside comprehensive rural and regional training. For more than a decade we have provided year-long training experiences for senior medical students in regional and rural areas.
These are now showing positive signs of graduates wanting to return to regional areas for junior doctor experience.
In the coming years these new graduates will be seeking places and specialities in which to work. These great training experiences seem to be influencing their decisions and highlight the regional focus already in place within the existing programmes.
What we really need is investment in the infrastructure of regional and rural general practice to help more practices become safe learning environments for students, junior doctors and specialists-in-training.
Furthermore, new iterations of general practice need to be developed so that a doctor can move between rural and urban practice in a flexible and financially viable way depending on family commitments and lifestyle preferences.
We also need to re-scope how rural health can be optimised in a rapidly changing world, taking full advantage of innovative use of new technologies and extended scopes of practice for our colleagues in nursing, pharmacy and community health.
Investment in these areas would be more productive for Maori health than building another medical school.
Papaarangi Reid is head of the department of Maori health at the University of Auckland medical school.
SOURCE: NZ Herald