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Much has been said of late about Medical School admissions at the University of Otago and our Mirror on Society policy. An internal discussion document about medical admissions, initiated by Prof Brunton and Otago Medical School dean Prof Rathan Subramaniam, was recently considered by the Medical Admissions Committee. The document considered medical admissions broadly and as part of that, our preferential entry programmes reflecting the Mirror on Society policy.
The intention of the discussion document was to allow us to pause and take stock of where we are and how we will move forward. Adopted in 2012, the Mirror on Society policy for our health sciences professional programmes is part of a far broader and longer-running drive by Otago to increase both the number of students from under-represented groups and improve their academic outcomes.
This commitment has been specifically articulated in the university's central strategic plan for more than two decades and will remain a firm commitment going forward.
Part of the context of the recent discussions is a current court challenge to the university's regulations and processes for medical admissions. While the university rejects the criticism of its existing processes, the legal challenge has highlighted the importance of ensuring that all admission decisions — including those through Mirror on Society pathways — are transparent and legally robust.
It has recently become clear that the challenge will argue that the university's ability to admit students through Mirror on Society pathways is limited by the proportions of relevant groups in society as a whole. This principle — which would slow the rate at which a representative health workforce could be achieved — is not one that the university accepts and which it will strenuously oppose before the court.
Over the past decade alone, the number of Maori studying at Otago has risen annually, increasing by more than 35% to reach 2187 equivalent full-time enrolments in 2019. As a result, Maori now comprise more than 12.5% of our domestic student cohort, up from 8.5% 10 years ago. Over the same period Pasifika enrolment has increased by more than 50%, with the university enrolling more than 1000 Pacific students for the first time last year.
Our attention to Maori and Pasifika is strongly aligned to the commitments successive Governments have made in these areas.
The focus has also broadened to include rural origin graduates, and more recently under Mirror on Society, initiatives have commenced to ensure a better representation of students from lower socio-economic and refugee backgrounds.
A significantly increased investment in equity-based scholarships and targeted outreach programmes has helped secure progress for Otago. Additionally, investment in academic and cultural support programmes and services has also supported the ongoing success of these students.
Many of the students we have supported through these initiatives are the first in their families — and often the first in their wider communities — to attend university, or gain entry to a particular academic programme. Their success is not only an achievement both personally and for whanau, it also serves as a powerful example for others of what is possible.
Otago's long and proud history of addressing Aotearoa's significant health workforce issues gained renewed impetus from 2010, with the launch of our Tu Kahika transition programmes for Maori seeking entry to health sciences.
Six years later, in December 2016, Otago celebrated the milestone of 45 Maori doctors graduating from Otago in a single year. We have graduated an average of 38 Maori doctors annually from 2016 compared with an average of just 14 per annum for the period 2010-2015. We have followed on with increases in the number of Pasifika medical graduates too.
We recognised this important milestone and what it meant for the future of Aotearoa and see it as a mark of success for the hundreds of people who helped make this possible.
The Mirror on Society policy is a cornerstone of admissions to health sciences professional programmes at Otago and we are justifiably proud of it. We are not stepping away from the commitment it represents.
While committed to equity initiatives across all areas, Otago will maintain a particular focus on health sciences professional programmes for a number of reasons.
Firstly, there is a gross under-representation of some key populations in New Zealand's health workforce, including Maori and Pasifika. Secondly, as New Zealand's largest health sciences university, we are uniquely positioned to help address this. Thirdly, the Ministry of Health has been keen to partner with us in initiatives that will over time produce a health workforce that is far more representative of the population it serves.
While recent comment on our Mirror on Society policy has focused on admissions to medicine, it is important to stress that this policy covers all of our health sciences professional programmes, including also dentistry, pharmacy and physiotherapy.
Significant progress has been made at the University of Otago in increasing the diversity of this broader health professional student cohort. By the end of 2019, for example, Otago had 371 Maori and 182 Pacific students enrolled across all years of its health sciences undergraduate professional degrees, comprising 12.4% and 6.1% of all students enrolled in these programmes. This compares with 9% and 3.7% representation respectively as recently as 2015. However, it is important to acknowledge that increased diversity has not been achieved evenly across all of our professional programmes. Medicine, to date, has been the leader in this regard and it is recognised that this is important for all disciplines at the university.
It is right that the university regularly pauses and asks important questions and has an inclusive and meaningful discussion with all our stakeholders. With the increased success of the policy, and with the Mirror on Society policy due for review in 2021, now is a good time to begin looking at some of the questions that the Medical Admissions Committee were beginning to consider, as part of a broader discussion across the division and key stakeholder groups. This might look at important questions such as:
■ What are the targets and timeframes for working towards representation of key groups in the health workforce? How are these best reflected in admission decisions and regulations?
■ How can admissions through Mirror on Society pathways be transparently balanced with all admission pathways within the caps set by the Government?
■ What are the key interactions between admissions decisions across professional programmes? How will such decisions assist in achieving increased representation across all areas of the health workforce?
These discussions will require careful consideration and broad consultation, informed by the university's commitment to Te Tiriti o Waitangi and its Maori and Pacific strategic frameworks.
Consultation will be done on the three principles of whanaukataka: embedding important and meaningful relationships; kotahitaka through collaboration: working with everyone who shares an invested interest on this kaupapa and ako, fostering a positive and reciprocal learning environment.
We will work through how best to have these discussions with key stakeholders, noting that no formal proposals will be considered without the opportunity for wide input and consultation.
In the meantime, we underscore that no changes will be made to the admissions regulations or processes this year for any of the programmes within health sciences.
We remain confident that all of the work currently taking place around medical admissions and our Mirror on Society Policy will give us an opportunity to reconnect, recommit and set a suitably ambitious vision for workforce equity.