Craig Riddell: Behind the white coat must be a friend

Craig Riddell agrees with quotas. Photo / Kellie Blizard

Opinion

Med school quotas are essential, student doctor Craig Riddell argues

The best doctors do more than use their understanding of science to help "fix" people. It is something Rodney Hide should remember.

Excellent doctors are confidantes, advisers and friends as much as they are scientists.

That's what makes Hide's column last week so ill-informed.

He does student admissions a grave disservice by trying to drag it down to the level of racial politics.

The University of Auckland produces excellent medical graduates and is regularly ranked within the world's top 50 biomedical faculties. It is fallacious to assume we are getting poorer-quality doctors because of quotas.

All medical students are held to the same academic standards once admitted. Moreover, grades are not a perfect predictor of excellence. Medicine is a mixture of art and science.

Strong interpersonal skills and commitment to extra-curricular activities mean more rounded people and potentially better doctors.

Even the notion of labelling the Maori and Pacific Island Admissions Scheme a quota separating the "brown" from the "yellow" and "white" students is reductionist.

I am Maori and did not enter medicine via the scheme. I'm also pale-skinned. Where would I fit into Hide's categories?

These admissions are not based on a crude calculus relating to skin colour but a holistic process that assesses a candidate's engagement with Maori and Pasifika culture.

Ensuring there are more Maori and Pacific doctors is a sincere attempt to address the glaring and damaging health inequalities in New Zealand.

Maori and Pacific people have worse health outcomes compared with other ethnic groups, even after accounting for differences in incomes.

This persistent gap is because of many factors. Unfortunately, one factor negatively influencing outcomes for Maori and Pacific patients is cultural differences affecting care provision by well-meaning doctors.

Research has shown that Maori and Pacific Island children are less likely to receive optimal asthma treatment, resulting in higher hospitalisations and deaths. These gaps demand redress.

All medical students are trained in relating to patients from all cultures but this alone is insufficient. To solve this problem we need to increase Maori and Pacific Islanders' participation in the health workforce.

Through this we can train doctors who are culturally fluent and not merely culturally aware, and who can act as agents of change towards better health for marginalised groups.

The University of Auckland's actions towards these goals are laudable, not lamentable.

Maori and Pacific students are not the only group with different admission standards. Similar logic underpins the Regional-Rural Admissions Scheme, which provides places for rural students to enter medicine based on an assessment of their connection to their local community.

Through this we hope they will return to practise medicine in rural settings. This is to counteract inequalities in care for rural versus urban patients and a dearth of domestically trained doctors servicing rural communities.

I admit that there may be students who miss out on a place in medicine because of these schemes but this small injustice is necessary in the face of wider societal injustices regarding health outcomes.

I am privileged to have trained alongside Maori and Pacific students admitted under this scheme.

Craig Riddell is the president of the Auckland University Medical Students' Association. He is in his fifth year of medicine and is based at Middlemore Hospital.