Deborah Hill Cone: Puzzling politics of preferential treatment

The University of Otago medical school reserves places for "rural" students. Photo / Getty Images

Meet Annie, who is 18.

She plays the saxophone, speaks fluent French, she's a whiz at 500 and - surprise plot twist - don't get into an argument with her. You'll lose. Trust me on that. She's my niece.

She's a remarkable young woman in other ways. She has grown up looking after her profoundly disabled brother Claude. I don't know how she can stay so patient with him.

Even when he tore up her babysitting savings (he might be autistic but he can tear bank notes), spilt an entire box of drinking chocolate in her bed and threw her phone in the swimming pool. Annie shrugs: "It got Claudified."

Annie has won awards as a gifted artist but since graduating from high school last year, I'm sad to say she's really let me down.

This year she went to Dunedin to study medicine. I know! You try to corrupt their young minds and bring them up to challenge the bourgeois status quo and what thanks do you get? They want to be a doctor.

I suppose I'll forgive her. Because she wants to become a doctor to help kids like Claude. And first year health science is hell - like Survivor in duffel coats. In her halls, only one out of 100 got into med school under general admission last year.

Anyway, Annie has been working like a fiend. It's tough but you tell yourself if you work your guts out you have just as much chance to get in as the next sleep-deprived zombie.

In fact, it's more like Team New Zealand starting the America's Cup one race behind.

And this is where as the protective aunty, I get all lioness-growly on her behalf. (Sorry Annie, but surely you're used to Aunty Deborah being a public embarrassment by now).

Because it turns out getting into the University of Otago medical school is not the same for everyone after all.

Let me explain. Take two similar students who both live in Coatesville and attended the same private school and have the same UMAT (Undergraduate Medical Admissions Test) score.

One of them, Annie, who moved to Coatesville as a high school student, will need an average of 93 per cent to get into med school (based on 2017 figures) The other student, who also lives in Coatesville and went to the same high school, would get in with 88 per cent because that student went to Coatesville Primary School, enabling them to apply under the "rural origins" sub category.

There are 55 places reserved specially for these so-called "rural" students. Rural is defined by the Department of Statistics.

The rural advantage is even greater if these two students apply on the other path, after finishing an undergraduate degree. The general applicant needs an A average; rural will get in with a B plus.

I know, right? Coatesville!

Coatesville is an affluent area on Auckland's northern outskirts known as the Hamptons of Auckland. It is full of large faux Tuscan houses built by Herne Bay stockbrokers who wanted a ride-on mower. If you live in Coatesville you are five minutes from one of New Zealand's biggest shopping malls. Yes, it's that rural.

Last month this paper reported Coatesville was Auckland's top priced suburb with an average sale price of $3.3 million.

Forgive me, but I find it hard to see how the pony club graduates of Coatesville are worthy recipients of a scheme which is intended to encourage more doctors into needy rural practices.

But maybe I'm missing the point. Perhaps this scheme works because those who get in under the rural-origins sub-category have to commit to being altruistic Doctors Without Borders types, taking their skills to the country's remote, deprived areas?

Nope and nope. Turns out the students in the rural origins sub-category are not bonded after graduation and are free to work wherever they like. They "may be" required to participate in a placement in a rural practice in their fifth year, but even this is not compulsory.

So I went to Peter Crampton, the University of Otago pro-vice chancellor and dean of health sciences and asked him about it. (Again, sorry Annie). Professor Crampton said six years ago the university introduced a policy called Mirror on Society to reflect the diverse communities of Aotearoa.

"Don't underestimate the politics of rural. The economy is dependent upon agriculture, tourism and fishing, much of which is based in rural communities. The maintenance [or not] of infrastructure in rural communities is a political issue."

He said the scheme has been a success, based on a 2014 paper in the New Zealand Medical Journal which he claimed found almost twice as many Otago students with rural background or training choose to work in non-major urban and rural locations.

But when I read the study it did not seem to support this conclusion. The study was based on a tiny sample (14 doctors) and the authors concluded the number of doctors with rural origins working in non-urban areas was not statistically significant.

I know the university has the purest motives for trying to encourage diversity and to support our rural heartland. I'm just not sure that preferential treatment for someone who grew up in the Dotcom mansion is the way to do it. It is stupid and unfair.