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There are limited spaces in the second-year programme and everyone in their first year has to reach a grade threshold.
But in a push to improve the diversity of the health work force, all Māori students who meet the minimum grade requirement, can identify their Māori heritage through whakapapa, and complete an essay showing their commitment to giving back to Māori communities, make it through.
It's known as the Māori Entry Pathway.
Once Māori students who have used the pathway make it into their second year of study, they are required to sit the same exams and reach the same standards to qualify as doctors like all other students.
Other students, who apply in the general pathway, compete for limited spaces and grades can become competitive.
Listen to RNZ interview
Third-year medicine student Tiana Mihaere has been told on many occasions the Māori Entry Pathway is wrong and unfair.
"I remember being in the dining hall one time and some girl was having a moan about how unfair the pathway was and it was just real blatant, dumb-arse racism.
"But it is a big problem. Every Māori student that does Health Science will have experienced some form of racism during that year."
She said its a lack of understanding about the state of Māori health, and the need for Māori in the health work force that leads to attitudes like this.
Figures from the New Zealand Medical Council show Māori make up just 3.4% of all doctors in New Zealand.
Third year medicine student Nadine Houia-Ashwell said the Māori entry pathway existed to lift that.
"Across the motu, across New Zealand, it's our Māori communities that are suffering the most from health issues and the university want to prioritise getting Māori students through because those students are more likely to go back to those communities and actually make a difference."
Ms Houia-Ashwell said Māori students were sometimes seen to get "special treatment".
But she said Māori had the worst health outcomes in the country and the university recognised that.
"I think the way people frame that is, 'oh you're Māori so you get this', and it's like, well, if I could trade off for the years of shit health, and the stuff my whanau have had to face, and all the shit that my ancestors have put up with then I would.
"But unfortunately that's not the way it is and it's part of the reason why we're here, is to change that."
The University of Otago has seen a steady increase in Māori students entering health professional programmes, with numbers rising from 138 in 2010 to 309 in 2016.
Associate Professor Jo Baxter said Māori needed to be at the forefront of improving Māori health outcomes.
"What we do know is that Māori in the work force make a real difference for Māori health so we have a great opportunity if we can grow the numbers in training then we will be able to grow the numbers out there in the work force.
"That will have a down-stream impact on making a difference to Māori health."
Ms Mihaere said her peers were generally accepting of the pathway once they become informed about why it was there.
"Individuals still use the excuse that Māori are the reason why they didn't get into med, and that's on them. But there is definitely movement in people's whakaaro once they become more informed.
"At the end of the day, once you're in, you still have to pass the exact same exams that everyone else has to pass. I think its just more around education, and that needs to happen at an earlier level, not at university."
Ms Houia-Ashwell had a message for those who don't understand why Māori entrance pathway is important.
"Take it upon yourself to learn about why we have these pathways.
"They're there for the exact same reasons you are, to get into medical school, and they come from these backgrounds that give them these unique lived experiences that perhaps not all students have had."
The Māori Entry Pathway has been used for more than 20 years. It shows how times have changed - Māui Pōmare, the first Māori doctor, gained his qualification in Chicago in 1899.