Disadvantaged students fight to get into medicine degrees. One's calling it out on TikTok

Fahad Kahn says he’ll work in Western Sydney when he finishes studying medicine. (ABC News: Marty Smiley)

At age 18, Fahad Kahn was sitting in a lounge room, eyes on his laptop, waiting for his ATAR score to pop up.

“My hands were trembling, I had sweat dripping, beads of sweat,” he says.

His dream was to get into a medicine degree and practise as a doctor, but it required a score in the high 90s. And as a student from a disadvantaged background, he was worried.

“I clicked on ATAR and it was 98.55 and I thought ‘Holy crap, that’s higher than anyone I’ve seen in ages in my school’.”

The result was a relief. All his hard work had paid off and now he was in with a solid chance.

For him, it was more than just a number.

Fahad grew up in Mount Druitt, a disadvantaged suburb in Western Sydney, supporting his migrant mother financially, who was dealing with domestic violence.

He lived in public housing for his entire adolescence and moved around a lot.

His school was known more for violence than its test scores.

He had no tutors, no special classes, and dealt with temperatures in his room that were so high they gave him nose bleeds.

Unlike many of the other aspiring doctors sitting the HSC that year, Fahad felt like he was behind before he even began.

“It’s a 100 metre race and I was starting 150 metres back,” he says.

“And then you’re expecting me to get to the finish line just as fast as other people, right? Which is totally unfair.”

And while in most stories an ATAR of 98.55 might have been the end of someone’s struggles, for Fahad more obstacles lay ahead.

Calculating disadvantage

Fahad’s ATAR was scaled up to 99.95 because he qualified for “disadvantage points” under the University Admission Centre’s Educational Access Scheme.

The system, which operates in NSW and the ACT, increases a student’s selection rank if they attend schools in low socio-economic areas, and for hardships they experience during years 11 and 12.

Fahad was awarded three points for his school, and one for his financial situation.

“My school was very proud. They put up a Twitter post. They put it on the electronic board outside, it was a really big deal,” he says.

He now had the highest selection rank possible.

But when he applied for the University of New South Wales’s medical degree, he was knocked back three times.

Fahad says he can understand being knocked back the first time — his medical entrance exam result, which all aspiring doctors have to take, was only 48 per cent.

But after the second and third time, when his score had improved to 72 per cent then 88 per cent, he began to question whether his disadvantage was being taken into consideration.

He wrote to the university seeking clarification.

UNSW replied:

“For the purposes of admission UNSW does not consider financial circumstances as demonstrating disadvantage. This is because most students experience some level of financial need, and work to support themselves. Financial circumstances are not considered beyond a student’s control once they reach university.”

Fahad was shocked.

“Does disadvantage disappear all of a sudden because I’m not in school anymore?

“Obviously not. Anyone with half a brain can look at the situation, say, ‘no, these things persist’.

“For me, the main thing it said was: ‘You’re not welcome, you’re not invited because you don’t fit the bill’.”

Fahad had one last attempt at the medical entrance exam and scored 98 per cent.

He got an interview with UNSW but ultimately chose to study at the University of Western Sydney, which he says is more aligned with his values.

After processing his experience, he took to TikTok, where he’s one of Australia’s most popular medical content creators, and made some videos calling out flaws in the different access schemes.

In his year 12 Educational Access Scheme application, he believes many of his hardships were excluded because of the time limit placed on them.

For instance, in his application, fleeing family violence and experiencing homelessness was ineligible for “disadvantage points” because they occurred before year 11 and year 12.

He also took aim at UNSW in a video that racked up hundreds of thousands of views.

And he had dozens of messages — a lot of them were from Western Sydney students.

The comments reflected anger at a university system that locks people from disadvantaged communities out of medical degrees.

The ‘Red Rooster line’

Cut a line across the city of Sydney, from Windsor in the north-west to Sydney Airport in the south-east, and a curious trend emerges.

On one side there are three Red Rooster take-away stores, while in the west there’s a whopping 27.

On one side is the more affluent and generally healthier part of Sydney. On the other, there’s double the rate of diabetes, an increased likelihood of heart attack and lower life expectancy.

Some see it as a line that divides the “haves” and the “have nots”, and Fahad was very much on the wrong side of that line.

Looking up at the lights of a fast food menu is where he learned a pretty handy hack.

He would calculate how many kilojoules he was getting per dollar to make his mum’s Centrelink payments go further.

“Cardiovascular, heart doctors, eye doctors, kidney doctors, diabetes doctors, general practitioner, psychiatry, needs more doctors.

“My goal is to be the thing that’s missing in the system right now and that’s to be a doctor in an area with workplace shortages.”

Fahad thinks that if more students from similar backgrounds could get into medical school, some of these problems could be solved.

He also thinks Western Sydney students can provide more nuanced healthcare.

“There’s a different culture here, there’s a different way of life here, and for you to not understand that will mean that you give your patients less ideal health outcomes.

“It’s not just about giving people a go for the sake of giving them a go. It’s about actually improving health outcomes.”

A tale of three doctors

In a medical clinic in Campbelltown, three GP registrars are in training to become doctors.

After work placements around Sydney, they find themselves at a critical juncture.

They must decide where to practise.

For Soraya — a Cairns woman who’s been working in south-west Sydney for 18 months — her first choice is eastern Sydney followed by her hometown.

“I want to be by the beach. I want to be around things that are happening, and for me that’s kind of the eastern suburbs at the moment,” she says.

Kristen, another GP registrar, will be working down the road from Soraya: “I grew up in Melbourne, moved to Sydney last year. So I’ve got a job in Glebe which is close to where I live in Newtown.”

And Jacob, a local to the area, says: “I’m happy to continue working in Western Sydney because I actually grew up around here, so it feels comfortable to me”.

Ken McCroary is the director of the clinic and the man putting the GP registrars through their paces.

He’s not surprised that out of the three, only Jacob — the local — has plans to continue working here.

Ken says many new doctors aren’t drawn to challenging environments, they’re drawn to high salaries.

“These guys aren’t dumb. You don’t do six or seven years of training and then another three or four years of specialty training and choose a speciality that doesn’t reward you,” he says.

“Why would I choose to work somewhere at $40 a patient when I could go an hour down the road and work for $110 a patient? That’s nearly three times as much for doing less work because it’s less complicated and you can probably get them [patients] through quicker.”

He says the South West Sydney region is on the precipice of a healthcare disaster.

“A quarter of all the GPs in some of our regions are aged over 65.

“If all my 75 year-old and 85 year-old GPs decide they just can’t do this any longer, we’re going to get smashed with shortages.”

He himself has tried to retire.

“But people go, ‘no, no, how will we replace you?’”

Ken says he’s stayed on so long because, like Fahad, he grew up around here.

He feels a sense of duty because it’s his community.

Emerging research shows it’s students from underprivileged communities who are willing to stay on and serve those areas — but currently they only make up 8 per cent of medicine and dentistry schools.

The federal government has set a target for students from low socio-economic backgrounds to make up 20 per cent of admissions across all disciplines. To reach that target, the Group of Eight, Australia’s leading universities, would need to triple enrolments from poorer suburbs.

Sending the elevator down

There’s a saying Fahad likes to quote:

“If someone sends the elevator down to you and they bring you back up, it’s your job to then send the elevator back down to help other people come up.”

Fahad thinks the prestigious universities, and the access schemes, are failing to do this.

“They’re just at the top of the elevator sitting there.”

He says calculating disadvantage by postcode is a poor way to determine who needs assistance.

“What if someone lives in, for example, Auburn, which is counted in the bottom 25 per cent, but the house cost $4 million? What happens then?”

He thinks using parental income would be a more efficient metric.

In a statement, the University Admissions Centre said that the system is automated using metrics from the census. That way students who may already be overburdened by their disadvantage don’t have to provide the paperwork themselves.

It also added: ‘Should a better means of identification and assessment become available we will fully explore it.”

Since Fahad’s three failed attempts at getting into a medical degree, universities have started introducing alternative pathways for low socio-economic status students.

Data on how many students are accessing these programs isn’t readily available for each degree at each university.

University of New South Wales wouldn’t provide its numbers, but its website states their alternative pathway program for medicine is capped at 10 students.

UNSW did tell the ABC that financial difficulties can now be used to demonstrate disadvantage.

Fahad’s not waiting around for things to improve.

He’s now in his fifth year of medicine, and he’s started teaching other aspiring medical students how to overcome the obstacles he faced.

A good chunk of his students are from disadvantaged backgrounds.

Some are from Western Sydney — people who, one day, might end up working locally.

For Fahad, it’s his way of sending the elevator back down.