Medical student selection in New Zealand: looking to the future.

AIMS To review whether current New Zealand (NZ) medical student selection policies are likely to result in specialists prepared to work in areas of greatest health need in the future. METHOD This paper describes approaches used to select medical students, with some details about NZ medical student cohorts. It then discusses the evidence linking selection and career choice. RESULTS AND CONCLUSIONS Selection processes have to serve multiple purposes and no tools are ideal. The NZ medical student population is more diverse than previously with more females than males, and higher proportions of students who are Maori, Pacific, rural, Asian or born overseas. Tracking projects are already underway to obtain data to better understand the effect of student factors on career choice. The Maori and Pacific Admission Scheme and Rural Origin Medical Preferential Entry affirmative action pathways have been successful, but to increase the number of doctors who identify as Maori or Pacific will require a larger pool of students with strong educational backgrounds from which to select. The strongest evidence between selection and future practice exists for students from rural backgrounds - they are more likely to practice in rural areas and to enter general practice. Therefore, increasing the numbers or rural students, or broadening the definition of 'rural', should be considered.