The Northern Territory now has two medical schools, but with an existing, successful partnership already in place, Dr Don Fuller argues that the new Charles Darwin University-Menzies program is an expensive exercise in duplication and may create an unstated incentive to enrol more full-fee paying international students rather that training Territorians, particularly Indigenous Territorians.

From February, a 42-strong cohort – including two First Nations students – will begin their studies through the Charles Darwin University – Menzies medical program. The program, which received 1900 applications, will be housed in a new $30.8 million Centre for Better Health Futures complex.

Many are left confused and wondering why it was necessary to largely duplicate the existing medical training partnership arrangements between CDU and Adelaide’s Flinders University that has been operating successfully at CDU since 2011.

This program, known as the Northern Territory medical program, was established to address the health needs of the Northern Territory.

Since its inception, the program has grown, with Territorians making up a high percentage of participants. It has included a focus on increasing the number of both NT and Aboriginal doctors.

It has involved working with local staff and medical infrastructure based in Darwin, Nhulunbuy, Katherine, Tennant Creek and Alice Springs.

The program is said to provide “unparalleled experience in rural and remote health, with a strong focus on Indigenous health and tropical medicine”.

From available public statements, the new CDU-Menzies program appears to be largely a duplicate of the existing and successful CDU-Flinders program in terms of the objectives and operation of the program.

To further confuse the issue, NT Health Minister Steve Edgington issued a press release aimed at spruiking and justifying the benefits of the new CDU-Menzies program, which appeared to refer to the benefits and substantial achievements of the existing CDU-Flinders program.

For example, the following comments can only refer to the CDU-Flinders program given the fact that the first intake for the training of medical students for the CDU-Menzies program only commenced this month.

“I’m pleased that a large proportion of NT Health’s Royal Darwin and Palmerston Hospital doctor-in-training workforce is continuing from 2025 into 2026, with a retention rate of 78 per cent, a significant increase on last year,” he said on February 4.

“In Central Australia, more than 40 trainee doctors have also chosen to stay on at Alice Springs Hospital in 2026.”

He added at Darwin and Palmerston hospitals, 50 intern doctors commenced alongside 36 resident medical officers, as well a further 100 registrars.

Such supportive comments by the Minister beg the question why it is necessary to largely duplicate an existing and very successful medical training program at CDU?

It also raises the question as to whether the Finocchiaro Government really understands what they are doing.

For the CDU-Flinders program, school leavers can take a six year pathway, consisting of two years of the Bachelor of Clinical Sciences at CDU in Darwin, followed by the four-year Flinders University medical degree. Alternatively, a four-year Flinders medical degree is available directly in the NT, for a post-graduate of an approved degree.

The new CDU-Menzies program is a five year, direct entry Bachelor of Clinical Science Medicine/Doctor of Medicine. It offers entry to recent school leavers who have completed Year 12 within the last two years. Applicants who have completed at least one year of full time tertiary study within the last 10 years, with sufficiently high scores, are also eligible.

One of the surprising and key standouts from information released recently by CDU in relation to the new program is the low number of First Nation students that have been accepted to commence study.

Numbering a very low two students, this stands in contrast to the relative importance of First Nations people in the Territory population, as well as the serious health challenges facing First Nation peoples in the NT.

This is most surprising given the objectives of the new program as a significant proportion of places were supposed to have been reserved for Indigenous applicants.

It suggests that the entry pathways may not have been designed in a manner to assist Indigenous students, who are unlikely to have been able to compete on the basis of Year 12 scores, or the completion of a year of full-time tertiary study within the last 10 years.

By contrast, around 10 per cent of the graduates from the CDU-Flinders program over the last 10 years have been Indigenous doctors.

In 2024 for example, the program reported that 10 Indigenous students enrolled in the first year of the program, or five times that of the new CDU-Menzies program.

The existing CDU-Flinders program facilitates the entry of Aboriginal people by enabling them to gain experience in completing a degree associated with medicine in the first instance.

This provides the necessary experience and skills to undertake further medical studies. They are able, for example, to bring prior work experience to their studies, resulting in higher levels of motivation, resilience and better capabilities to handle the demanding nature of medicine and medical study.

Statements by CDU indicate a relatively high number of applicants for the new CDU-Menzies program. However, many school leavers and recent graduates are keen to study medicine, given the job opportunities and income-earning potential for this occupation.

The important question left unanswered by CDU management is where such applicants actually originated from. For example, was it the NT where the new program is supposed to be focused, or were they overseas students?

It would be expected for example, that a great many students applying for such a program would originate from developing Asian countries. However, the new program claims to be focused on Territory students and Territory health requirements, rather than being used as a ‘cash cow’, to drive up flagging CDU revenues.

A major additional problem associated with the new CDU-Menzies program is an apparent inadequate workforce and economic analysis on the likely impact of this duplication and doubling of the graduate medical output on the wider responsibilities of the NT hospital and health system.

This lack of economic analysis and planning is in common with many new projects in the Territory and is the principal reason behind huge cost blow-outs and project failures.

Doubling the number of medical students in the NT can be expected to cause major problems for the wider NT hospital and health system which will need to be heavily involved in the clinical on-the job training of such medical students.

There is not likely to be sufficient clinical supervisors available in NT hospitals to contribute to this essential training. This will have a major impact on the level and quality of training that will be available to medical students.

In addition, other required resources, including facilities within hospitals will be under severe pressure, as students from the existing CDU-Flinders program and James Cook University are forced to compete with the new CDU-Menzies program for limited positions and resources within the NT hospital system.

This appears as a classic case of university administrators rapidly increasing the numbers they wish to train for revenue generating purposes without taking account of any downstream impacts on other organisations and institutions likely to be affected by their decisions.

Other recent examples have included the university’s sudden increase in the training of lawyers without concern whether suitable positions were likely to be available for such students on completion.

This led to a significant over supply of young law graduates, many of whom were unable to get a position to undertake the required on-the-job clerkship training with an existing law firm.

Many have since been unable to work within the occupation they spent many years studying for.

Such a serious lack of strategic understanding and analysis of the wider medical workforce is likely to place severe pressure on prospective employers and students but also directly impact the ability of the NT hospital and health system to provide the required services to the wider community in the NT.

This is likely to occur as resources that need to be directed to NT community health problems are diverted into medical training.

A direct example of this misallocation of priorities in the NT health system occurs in the funding arrangements for this duplicated health training program at CDU.

The Commonwealth has committed $24.6 million for the operation of the CDU-Menzies medical school.

A separate, new $30.8 million health teaching and training facility has been constructed to house the medical school. This capital investment was jointly funded with the Federal Government providing $15 million and CDU $15.8 million.

This can be expected to add additional pressure to an already stretched CDU budget. For the year ended December 2024, the latest figures available, CDU reported a comprehensive loss from continuing operations of $11.2 million, down from $31.3 million in the previous year.

In the year ended December 2024, borrowings were at a very high $126.5 million up from $118.3 million the previous year.

Duplicating an existing, successful program not only puts a high degree of unnecessary pressure and risk on CDU as an operating entity, it also has a major effect on diverting badly needed funding away from struggling and deficient medical services in other regional centres of the NT, as well as desperately needed health facilities within Aboriginal communities.

The current vice-chancellor of Western Sydney University, Professor George Williams, a professor of constitutional law, told a recent Senate inquiry that community confidence and trust in universities needs to be rebuilt.

“The sector is plagued by a crisis of community confidence,” Prof Williams said.

“The current funding and regulatory arrangements have led to a reliance on international student revenue to make up shortfalls, ­perceptions of universities as too corporatised, and governance ­failings.”

Interestingly, Prof Williams succeeded Barney Glover, as the vice-chancellor of the Western Sydney University. Mr Glover had also previously been vice-chancellor of CDU. Professor Scott Bowman the vice-chancellor of CDU had previously been senior deputy vice-chancellor at Western Sydney University in 2019 and worked with Mr Glover from 2019 until he became vice-chancellor of CDU during 2021.

It is perhaps no surprise that Mr Glover has been active in assisting with the notion of a separate medical school for CDU and was instrumental in providing CDU with the curriculum from the Western Sydney University Medical School while vice-chancellor there, for use by the CDU-Menzies new medical school.

The benefits of such a duplicated new medical school are difficult to fathom.

It may provide the opportunity for additional access to more taxpayer funded finance through both Commonwealth and NT governments.

It may also provide an unstated opportunity to enrol more full-fee paying international students.

It is unlikely however, that a proper economic and risk-analysis would have indicated that the benefits of such a largely duplicated and unnecessary program would outweigh the substantial costs.

Surely, the far better and wiser approach would have been for CDU to discuss any changes they thought necessary for the benefit of CDU, directly with their original partner Flinders University, rather than consume a large amount of taxpayer financial resources by establishing a separate program, in such a risky venture.

In such a situation, it would not be surprising that the program may be viewed by many, as an exercise in university senior management empire building, with questionable benefits to the NT.

Dr Don Fuller holds a first class Honours degree and PhD in economics from the University of Adelaide and has worked as a senior public servant in the Territory and as Professor of Governance and Head of the Schools of Law and Business at Charles Darwin University. He grew up in Darwin and attended Darwin High School.

He was also involved with the establishment of the first NT medical school under the leadership of Flinders University vice-chancellor Professor Ian Chubb.

Dr Fuller was also an adviser to the former CLP MLA Maralampuwi Francis Xavier, was briefly the senior private secretary to Chief Minister Paul Everingham, and is a former member of the CLP and the ALP.