I know for many people affirmative action programmes are a real sticking point. A new report in the New Zealand Medical Journal, has found that affirmative action programs at the University of Otago have however, significantly lifted Māori, Pacific, and rural enrolments over the last 30 years. Where they have failed is increasing the student numbers from poorer backgrounds.   So people don't like them, but they do actually work. Māori made up 20% of enrolments at the university's medical school over the last four years, reaching parity with European and Asian enrolments for the first time. For a very long time, that wasn't the case. Ten years ago, 7.6% of new domestic medical students at Otago identified as Māori, 2.7% as Pasifika, so that shows up in the workforce in which only 3.4% are Māori, 1.8% Pasifika. However, after more robust affirmative action policies were implemented at our medical schools there was a big change. By 2016, Māori and Pasifika students entering Otago Medical School had increased by 179%. Māori were about 16% of domestic students, Pasifika about 5.6%, which is pretty much in line with how they're represented in the population.   However, health profession courses at Otago are still dominated by students from wealthy backgrounds and top schools, despite rare efforts to recruit more people from poorer communities. So, if you're wealthy you're going to be fine if you want to be a doctor, you're going to be particularly fine if you're wealthy, comfortably middle class and Māori/Pasifika. Barack Obama famously said his two daughters, who have grown up in a privileged background, should not benefit from affirmative action programs when they are competing with students from poor white families.   What's more important? Your ethnic identity or your background? It's easy to dismiss affirmative action as racist or lowering standards, but just remember that if you're a woman you have been able to benefit enormously from affirmative action in just about every sphere of society - law, engineering, medical school. There was a time when it was thought only men had the brains and the mettle to make it in medicine. Affirmative action opened the door to women and now it's no longer needed. Women can see it and know they can be it.   Women now make up nearly 2/3 of all enrolments in health professional programs, up slightly from 1994. In fact, universities are starting to be concerned by the relative underrepresentation of young men in tertiary education and may well have to have a program encouraging young men to enrol at university in a number of courses. Places may well have to be kept for men in law school so that their profession is not flooded with women.   When you look at people who have received scholarships, you cannot really go past Sir Peter Buck, and this was at a time when standards were phenomenally high for anybody entering the profession. He went to Te Aute College, the Māori secondary school, got a scholarship to Otago University, where he graduated in medicine. He was awarded so many degrees, from so many prestigious universities —Yale, Rochester, Hawaii— he received military medals for distinguished service in wars, he was an anthropologist, he worked in public health. This was a scholarship kid, he did okay.   As did Māui Pōmare, which are from the young Māori Party who were a phenomenally talented group of young people and went on to equit themselves at the very highest level, with the very highest honours. Not every scholarship kid's going to be like that. Not everybody who is a recipient of affirmative action is going to be like that. Once you're in, you have to pass. And I don't know about you, but there are some incredibly clever, clever people who become doctors who probably shouldn't. They're smart, no doubt about that, they ace the exams. But when it comes to people? Not so much. Maybe they should go into pathology where they can just cut up dead things rather t