Documents released under the Official Information Act showed the Tertiary Education Commission recently corresponded with both Universities Minister Dr Shane Reti and Waikato University about the plans.
It told Dr Reti in March that "Waikato has a strong commitment to the third medical school and has gone ‘all in’ to support the progression of this investment".
The TEC acknowledged Waikato’s management had historically been "responsive to financial shocks", and was confident it could respond to financial pressures as they arose.
However, it cast doubt on its ability to push ahead with the medical school proposal.
"If the third medical school goes ahead, close monitoring of its financial performance will be required and we have been clear to Waikato that its risk profile would likely increase to high-risk given the scale of the project and investment."
The TEC was also critical of Waikato’s overall academic performance, saying while results had been improving and student growth had been steady, "Waikato delivers educational outcomes below the university sector average" and "continually performs within the bottom half of university educational performance indicators".
The university’s finances also came under scrutiny — the TEC noted Waikato had recorded deficits in 2020, 2022 and 2023, with the "underlying deficit" as high as $20 million in 2023.
The TEC said the proposed investment in a new medical school "underpins a strategy of significantly increasing its health-related programmes" — this year, Waikato has been approved to deliver new graduate-entry master’s programmes in pharmacy and midwifery — but at present it had "low volumes of health-related delivery".
A letter to Waikato University vice-chancellor Prof Neil Quigley from the TEC reiterated many of these concerns and asked for evidence of financial planning.
The TEC’s letter said it graded Waikato as being of "medium risk" financially in its present state before the medical school establishment process went ahead.
"We would expect Waikato to have an extremely clear view of the overall impact the investment [in the medical school] would have on its wider financial performance."
The proposed third medical school has proved controversial with the University of Auckland and University of Otago, which together provide New Zealand’s existing medical training.
Both argue they can train more doctors more efficiently and effectively than establishing a new medical school.
Green MP Francisco Hernandez said the latest release was "just another layer on the mountains of evidence which show the proposal simply doesn’t stack up".
"Given that the government has been warned that approving the Waikato medical school would likely increase the risk profile of Waikato University to high-risk, it’s clear that the right thing to do is reject the proposal.
"Everyone in Aotearoa deserves a thriving, well-resourced public health system, and expanding the medical training pipeline is a key component of this," Mr Hernandez said.
"The best way to do this is by investing in expanding placements at Auckland and Otago, not backing risky projects pushed by private interests and lobbyists."
Health Minister Simeon Brown said ministers were still considering advice received from the Ministry of Health on the Waikato medical school proposal.
"Under the National-Act New Zealand coalition agreement, a full cost-benefit analysis must be presented before any decision is made with respect to the Waikato medical school."
A Waikato University spokeswoman said it had no comment on the risk assessment provided by the TEC.
