White supremacy, privilege and "meritocracy" were stubborn hurdles to a more just approach to student selection, public health specialist Prof Peter Crampton and colleagues contend in the New Zealand Medical Journal today.
"Current health policies prioritise much greater Maori participation in the health workforce," they wrote.
"However, the vision for a health workforce where the entry door is open and where Maori participate fully is a very long way from being realised.
"The key to this door is in the hands of the education sector."
Meritocracy referred to the idea that power and authority should be vested in individuals on the basis of talent, effort and achievement.
Universities could better serve the needs of society by redefining merit to be a concept that placed value on indigenous perspectives and a lived understanding of socioeconomic adversity, the Otago academics said.
Students from adverse socioeconomic backgrounds had skills, strengths, knowledge, experiences and attributes "that mean we cannot treat them the same as students from privileged educational backgrounds, but they should be able to benefit from and contribute to higher education, as an entitlement of citizenship".
"By defining those attributes and experiences as meritorious, as opposed to unfortunate liabilities, we welcome into our institutions students who can offer much to our universities and to society."
Prof Crampton was assisted by Zoe Bristowe, who manages Maori health development programmes, and public health physician Prof Jo Baxter, and they all work in Kohatu, the Centre for Hauora Maori at the University of Otago.
They used the university’s medical programme as a case study.
The university had historically resisted proactively implementing effective strategies to expand the training of Maori doctors, dentists, physiotherapists and other health workers, they said.
A growing number of Maori medical graduates had emerged since a "pro-equity" selection model was brought in, "illustrating that, even when the structures of opportunity are hostile to Maori, it is indeed possible to achieve change".
The authors said securing necessary resources for transformative change was one of the tasks of leadership.
"In practice, this meant that resources for the support of Maori staff and students were a key area of focus."
Educational institutions were doomed to carry on "swimming around in a soup of conceptual muddle and prevailing meritocratic ideologies" if they lacked understanding of Maori histories, strong anti-racism theory and critiques of prevailing ideologies.
The authors argued principles of meritocracy and the ideology of white supremacy had ensured barriers to higher education remained in place, although well camouflaged.