Proposal for the New Zealand Graduate Entry Medical School at the University of Waikato

The University of Waikato has proposed the creation of the New Zealand Graduate Entry Medical School (NZGEMS) based on the proven success of international models of community-engaged graduate entry-only medical schools.

These schools select students who have already completed a three-year undergraduate degree and provide them with four years of intensive, practical medical education, as opposed to six years at the existing medical schools in New Zealand, the majority of whose students are school leavers.

New Zealand currently has a critical shortage of doctors, as demonstrated by unacceptably long wait times for an appointment with a GP, treatment at the emergency department of a hospital, and non-urgent surgery through the public health system.

New Zealand is also more reliant on overseas-trained doctors than any other OECD country. The doctors we import from overseas make up a very high proportion of the primary care workforce in high needs communities outside the main centres, especially in specialties such as general practice and psychiatry. Additionally, most do not stay in New Zealand permanently (before the Covid-19 pandemic, only 20% of our imported doctors were still in New Zealand five years after recruitment).

We need to import so many doctors from other countries because New Zealand has one of the lowest ratios of medical schools, and of medical training places, relative to population, of any country in the OECD: we have one medical school for every 2.35 million people, while Australia has one primary medical school per 1.2 million people, and we have 109 first year medical school places per million people against Australia’s 160 places per million people.

New Zealand is particularly short of doctors in primary care and outside the main centres because of the student selection and training models currently in place in New Zealand. The international literature in medical education is very clear: that our health workforce outcomes are a function of how we select students and where we train them. A student from a small town is much less likely to aspire to provide primary care in their home town after spending eight years, the majority in a tertiary hospital setting, in Dunedin or Auckland.

The New Zealand Graduate Entry Medical School will have a commitment to primary care as its operational and philosophical core. Primary care practitioners work across a range of areas, including preventative medicine, chronic disease management, mental health, child health and acute care medicine. Our school will achieve different health workforce outcomes by selecting students who are committed to careers in primary care and to serving high needs communities outside the main centres, and ensuring a high proportion of their training occurs in these settings.

The NZGEMS proposal follows a widely accepted and successful model currently in use in Australia and Canada. Internationally, the distributed education model has been shown to both lower the system-wide costs of ill health by improving access to health care, and foster economic development to provide benefits that far outweigh the cost of investment. The NZGEMS will not only have different workforce outcomes from New Zealand’s existing medical schools, it will improve access to healthcare for high needs populations and contribute to achieving social and economic equity.

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