Socio-demographic profile of medical students in Aotearoa, New Zealand (2016–2020): a nationwide cross-sectional study

• Published in: BMJ open Vol. 13; no. 12; p. e073996
• Main Authors: Bagg, Warwick, Curtis, Elana, Eggleton, Kyle S, Nixon, Garry, Bristowe, Zoë, Brunton, Paul, Hendry, Chris, Kool, Bridget, Scarf, Damian, Shaw, Susan, Tukuitonga, Collin, Williman, Jonathan, Wilson, Denise, Crampton, Peter
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 07.12.2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Adolescent; Adult; Citizenship; Colleges & universities; Correspondence; Cross-Sectional Studies; Demography; Ethnicity; Ethnicity - education; Female; Gender; Health Education; Health Equity; Humans; Male; Maori People; Medical education; MEDICAL EDUCATION & TRAINING; Medical Education and Training; Medical students; Medicine; Native rights; New Zealand; Rural areas; Rural health care; Schools; Sociodemographic Factors; Sociodemographics; Students, Medical; Women; Workforce; Young Adult; New Zealand; Niue; Tokelau Islands; Health Equity; Health Education; MEDICAL EDUCATION & TRAINING
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-073996

ObjectiveTo determine the socio-demographic profile of all students enrolled to study medicine in Aotearoa New Zealand (NZ).Design and settingObservational, cross-sectional study. Data were sought from the Universities of Auckland and Otago, the two NZ tertiary education institutions providing medical education, for the period 2016–2020 inclusive. These data are a subset of the larger project ‘Mirror on Society’ examining all regulated health professional enrolled students in NZ. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. NZ denominator population data (18–29 years) were sourced from the 2018 census.Participants2858 students were enrolled to study medicine between 2016 and 2020 inclusive.ResultsThere were more women (59.1%) enrolled to study medicine than men (40.9%) and the majority (96.5%) were in the 18–29 years age range. Māori students (rate ratio 0.92; 95% CI 0.84 to 1.0) and Pacific students (rate ratio 0.85; 95% CI 0.73 to 0.98) had lower overall rates of enrolment. For all ethnic groups, irrespective of rural or urban origin, enrolment rates had a nearly log-linear negative relationship with increasing socioeconomic deprivation. Enrolments were lower for students from rural areas compared with those from urban areas (rate ratio 0.53; 95% CI 0.46–0.61). Overall NZ’s medical students do not reflect the diverse communities they will serve, with under-representation of Māori and Pacific students and students who come from low socioeconomic and rural backgrounds.ConclusionsTo meaningfully address these issues, we suggest the following policy changes: universities commit and act to Indigenise institutional ways of knowing and being; selection policies are reviewed to ensure that communities in greatest need of doctors are prioritised for enrolment into medicine (specifically, the impact of low socioeconomic status should be factored into selection decisions); and the government fund more New Zealanders to study medicine.