Otago University public health Prof Peter Crampton, who works in Kohatu, the centre for Hauora Māori , said the National-led government’s coalition agreement to "examine the Māori and Pacific admission scheme and its Otago equivalent to determine if they are delivering the desired outcomes" could potentially become fraught.
"These debates come up periodically in the political sphere.
"Affirmative action pathways have existed since the 1950s, albeit in radically different forms.
"Unfortunately, the negative attention that is drawn to Māori and Pasifika students as part of the debate has a direct negative impact on their sense of legitimacy at the university."
Prof Crampton said the medical school had affirmative action pathways for Māori , Pasifika, and rural students, as well as those from low socioeconomic and refugee backgrounds.
The scheme is known as Te Kauae Parāoa, and supersedes the Mirror on Society Selection Policy which existed for nearly a decade.
Since 2017, Otago University has admitted 385 Māori medical students, 136 Pasifika medical students, and 332 rural medical students through the scheme.
"Affirmative action is a powerful tool in the toolbox in addressing inequities in the health system.
"The health system should be a mirror on society, it wasn’t that long ago it was dominated by old white men.
"It took a shift in social attitudes to address this."
Prof Crampton said about 30% of second-year medical students were Māori or Pasifika, roughly in line with population demographics.
The pass rate of those students from the medical programme was over 90%.
"Everyone who goes through the school is highly capable and willing to give back to society.
"The shifting of the dial of Māori and Pasifika health outcomes will be achieved in part through having the health workforce reflect the composition of New Zealand society.
There were massive "inbuilt institutional biases" in the health system that needed to be overcome, and the role of those admitted through the pathways went beyond their role as clinicians.
"Their contribution to society is huge.
"It’s about a great deal more than the numbers. The University is strongly committed to producing the best quality outcomes to healthcare, and part of that is reducing the inequities."
The university anchored its work in public health policy, and had received significant support from the Ministry of Health in developing its pathway schemes.
"The health system is an intensely human undertaking."
Asked about whether the university would be willing to have their pathway’s schemes examined, Prof Crampton said: "we have a great deal of data to share, going back more than 30 years".
"The university welcomes the opportunity to discuss the programme and its successes."
The fact the pathways schemes offered places for rural medical students was often ignored in public debates, he said.
"Rural student success is a big component of the scheme, and has been there for a long time."