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Kia ora! The student loan extension makes medicine fairer for all whānau

Medical student Kera Sherwood-O’Regan on what the student loan extension means for Māori studying medicine.

“Have you seen the news?!”

There’s nothing like waking up to dozens of messages and tweets to jolt you out of bed with a deep sense of dread. I tried to keep a lid on the panic as I wondered who had passed away.

I definitely didn’t expect to be waking up to a win.

After fumbling for the light switch and adjusting the glare from my seemingly radioactive phone, there, staring back at me from the screen was not an image of a war hungry dictator, or a moving obituary, but Minister Chris Hipkins smiling with a headline that caught me off guard: “Student loan cap lifted to 10 years for long courses.”

Mundane as it sounds, I was floored.

The student loan cap was introduced by the previous National government to limit loans to only seven years of study. While that may sound like a lot, for those students who are in long courses (like medicine and veterinary science), those years go by pretty quickly.

An additional EFT (roughly equivalent to one year of study) was made available for students in these particular courses. However, it still meant that many students would have to either drop out of their programmes, or stump up a minimum of $15,000 per year for fees alone.

My current degree, medicine, is six years all up. Around a quarter of our class are graduate students, like myself, who have already completed another degree, thus chewing up their “EFTS” entitlement. Ditto students who have also completed bridging or foundation courses.

Some have found that after getting a bit of study under their belt, they can make a more meaningful contribution as doctors. For others, medicine has always been their dream but maybe they didn’t make it through the competitive selections first time around.

So why is this an equity issue?

The whole situation is complex, but let’s just start with the basic premise that not everyone comes into medicine or pre-med studies on an even footing.

It’s a highly competitive entry programme with high stakes, and as seems to be the rule for all such situations, the difference between the haves and the have-nots turns into an ugly, gaping chasm of inequity.

There is an entire industry involved in getting kids into medical school. From the well-to-do schools that can stream their students into advanced classes, to the private education companies who charge hundreds of dollars per session for always sold-out courses to get students through exams.

You can guess which kids you see in those rooms.

And when these are the people growing up to be the future of our medical workforce, then you can guess what that looks like at the moment too.

So despite having amazing targeted entry schemes, excellent Māori health programmes, and bridging and foundation courses set up to make our health system more fair (run by the likes of preeminent professor Papaarangi Reid and Dr Rhys Jones) the student loan rigmarole was yet another barrier for our tauira.

The change to the student loan cap is one more step in the right direction, chipping away at a system where our people are the ones in hospital beds, and not the ones working the hospital floors. Where our people are expected to top all the shitty health statistics, but never top our classes.

For me personally, the cap took more of a toll on my own medical studies than even I realised before Monday morning.

I was privileged to work with the incredible team at Te Oranga and NZMSA last year. Their dedication and commitment to the kaupapa of extending the time period, and especially to equity, is something truly remarkable. There was relentless letter writing to ministers; petition writing; press releases; media interviews; filming and sharing student stories all over social media; and securing promises from all current government parties before the election.

Yet even with this Herculean effort from the team, and the huge support received from the campaign experts at ActionStation, I’ve worked on campaigns long enough to know that even the most principled of politicians are going to let you down some day.

So while all my colleagues talked about “When we graduate…” and “When we’re doctors…”, the loud voice of doubt in my head would correct them- “Not when, if!

It felt like a dangerous luxury to let myself dream about finishing, when that reality was going to require somehow wrangling upwards of $45,000 from my friends and whānau (to say nothing of the roughly $120,000 I’d already invested in my studies). I was becoming resigned to the fact that being a doctor just wasn’t going to happen for me.

Waking up to the news that I’d only have one more year of study to pay upfront… that was both the most overwhelming relief, and the most confusing career plan shift I’ve experienced to date.

My feelings about how this policy affects me are complicated, but the more profound sense of relief I have isn’t.

That relief comes from knowing that far bigger than me, this policy will affect so many students to come, so many whānau, and so many patients. It’s not a magic bullet, but it’s going to put a whole bunch of possibilities on the table for our people to feel respected, and heard, and seen in our health system.

This policy is going to make medicine fairer.

It’s going to mean that our rangatahi who didn’t have the privilege of attending King’s College or Auckland Grammar, but instead call Manurewa, Waiuku and Kelston home have support that gives them the best shot at getting into this competitive degree. They can go do Hikitia Te Ora or a Tertiary Foundation Certificate, or whatever they need to prepare, without worrying about running out of student loan.

It means that our tauira can dedicate their precious time to actually studying, rather than to working multiple jobs and chasing pūtea.

It means that they can take time to study our te reo, and gather other valuable knowledge for their kete – all which will help them become the diverse doctors our communities so desperately need and deserve.

It means that when our people are sick and at their most vulnerable, they’ll be able to see faces like theirs, doctors who speak their language and who ‘get’ their whānau. Doctors who know when it’s medically necessary to tick certain boxes, and when it’s time to set down the checklist and have a deep and meaningful connection with the patient, *ahem*, person sitting in front of them.

I’m not suggesting that an extra two years of student loan is going to magically reverse colonisation, or over a century of policy that has disadvantaged our people. But it’s a step, and an important one in the right direction.

And that’s a pretty choice feeling to wake up to, nē?

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