GRAHAM ADAMS: MAPAS defenders fudge facts on competence

The sight of a bevy of politicians using the same spoon-fed lines to justify a particular party policy is so familiar that it has become unremarkable, if sometimes laughable.

But while it is standard fare for MPs to obediently circle the wagons around their leader, it is disconcerting — and disappointing — when doctors use similar stock tactics to defend a policy that is under intense public scrutiny.

Whenever doctors are questioned about the Māori and Pacific Admissions Scheme that gives preferential entry to Māori and Pacific Islanders, it is a safe bet those in favour of it will use an identical statement in its defence — that all MAPAS students pass the same exams as their classmates.

The implication is that no matter how much lower some MAPAS students’ grades are than their peers’ before being accepted into Med School, once they enter the magical kingdom of biology, pharmaceuticals and cadavers, they will suddenly perform at much the same level as their much-smarter colleagues. 

Thus Professor Warwick Bagg, dean of the University of Auckland’s Faculty of Medical and Health Sciences, told RNZ’s Guyon Espiner this month: “All medical students, regardless of admission pathway, must meet the same academic, clinical and professional standards before they graduate.”

On LinkedIn, Dr Aniva Lawrence — damning David Seymour’s push to have MAPAS abolished as a “divisive, racist electioneering tool” — wrote: 

“As a proud MAPAs graduate, I would not have been able to do medicine without this entry scheme… I entered a foreign environment, sat and passed all the same exams as my general entry classmates.”

In a column titled, “David Seymour is afraid of MAPAS because it’s working”, Professor Papaarangi Reid, who is also a MAPAS graduate and heads the race-based admissions programme at Auckland University, made bolder claims:

“Once we’ve supported [MAPAS students’] access, we require everyone in the medical programme to achieve the same academic and professionalism standards.

“All medical students must pass the same exams at the same pass rate. They all meet the same level. The doctors produced are all of the same standard.”

It won’t be obvious to all readers but there is linguistic sleight of hand at work here.

Asserting, “All medical students must pass the same exams at the same pass rate” means only that the cut-off point for failing is the same for everyone.

And the claim that all medical students perform to “the same standard” and “the same level” means no more than every graduate is required to meet the minimum standard for registration even if some only scrape through.  

It certainly does not mean students all achieve the same academic grades or levels of competence, even if Professor Reid appears to imply that.

So while the assertions may be true in a narrow sense, they are selective truths that skate over significant differences in academic and clinical capabilities.

What gives the game away in Professor Reid’s case is that she goes on to say… “many of us complete our degrees with distinction, some are top of the class in various subjects”.

Readers might wonder how, in the supposedly egalitarian learning environment of medical school, some MAPAS students actually outperform their classmates.

In fact, medical students are repeatedly tested and graded throughout their medical education.

As one student put it: “Every few months, we have a progress test, with questions based on clinical scenarios, and what to do in each patient case. This test is taken by every Auckland University medical student across all years, at the same time.”

And there are several prestigious prizes for the best students in a very competitive field. Clearly, not every student is at “the same standard” and “the same level”. 

The saying “C’s get degrees” is apt.

Unfortunately, the media rarely, if ever, looks behind the statements made by doctors and academics promoting race-based entry and as a result the public mostly comes to believe their assurances that all graduates of Auckland’s medical school are, without exception, highly competent. 

However, the wider medical fraternity is not so easily  persuaded. There is considerable disquiet among doctors about the competence of some MAPAS graduates, even if they are very reluctant to criticise the programme publicly lest they be accused of racism.

Nevertheless, some will speak privately.

A senior surgeon told me:

“It is clear to me that some MAPAS students are pushed through, and everyone at the medical school knows who they are. In my opinion, their standard is well below what is acceptable to graduate.

“I believe, therefore, that when they do graduate from medical school, they are very ill-equipped to practise as doctors.”

A specialist in private practice said when he was at med school he was known as a “nerd” and struggling MAPAS students often came to him for explanations of course material they couldn’t understand. He said he was frequently dismayed by their lack of basic medical knowledge and doubted that even with the extensive extra tuition they received as part of the preferential entry programme they could become effective doctors. 

This should hardly be surprising, of course, given the gulf in academic standards between some MAPAS entrants and those enrolling via the General category.

A response to an OIA request for a breakdown of applicants for Auckland Med School’s 2024’s intake showed the median Grade Point Average for successful graduate students under General admission was 8.5; for MAPAS applicants it was 6.25.

The lowest GPA score for General admission was 7.25 while a score of 4 sufficed under MAPAS.

So while the lowest successful candidate in the General category required an overall mark averaging A- (above 80 per cent), the lowest of the MAPAS entrants needed only a B- average (between 65 and 69 per cent).

The difference in intellectual power between a B-minus and A-minus student is vast.

It is equally true that some MAPAS students are very bright. The highest Grade Point Average (GPA) gained by a successful MAPAS applicant in 2024 was 9. It signifies a grade of A+, which requires a mark of between 90 and 100 per cent.

Why such a capable student would choose to compete in the race-based programme rather than the General category is not hard to fathom.

In 2024, for example, 115 applicants competed for the corresponding 115 places initially set aside under MAPAS. Anyone with very high grades and even a single great-grandparent who was Māori or a Pacific Islander would be virtually assured of a place. 

In the General category, however, there were 531 applicants competing for 98 places (boosted to 164 after not enough Māori / PI candidates were found suitable to fill the reserved MAPAS places).

Given the high number of applicants with stellar academic results in the General cohort, the competition would be stiff even for an outstanding Māori / PI student with a GPA of 9. 

For such an academically successful student, choosing the race-based entry programme is a no-brainer. After all, candidates do not even have to show they are actively involved in traditional Māori or Pacific culture or their communities, or speak their language. Nor do they have to look obviously Māori or Pasifika, which gives the lie to the claim that their patients need doctors who look like them.

The MAPAS application begins with a simple, bald question:

Are you descended from a Māori?

or

Are you descended from an Indigenous Pacific person?

A significant downside of having such a blatantly race-based path, of course, is that even very capable Māori or Pasifika doctors — including the excellent Pasifika surgeon who operated on my broken thumb five years ago — can’t entirely escape the widespread suspicion among the public that they may be medical imposters.

Graham Adams is a freelance editor, journalist and columnist. He lives on Auckland’s North Shore.