Read the speech that earned a standing ovation at the AMA’s national conference this past weekend.
Speaking at the AMA’s national conference on Friday 28 August, Australian Medical Students Association president Seniru Mudannayake urged the association to continue backing AMSA’s campaign for a fairer medical training system.
Mr Mudannayake has proven to be an especially vocal and eloquent AMSA president.
It will come as no surprise to some readers, then, that his conference speech earned a standing ovation from AMA conference delegates.
Reprinted below is a transcript of that speech.
I want to begin by thanking all of you, on behalf of AMSA, for your support and advocacy, particularly the federal and state AMAs, MDANZ, and all the other colleges for being very supportive of us in our various fights.
I think that medical students now more than ever are starting to feel some of the disillusionment that many of you in the room feel when it comes to health politics and policy.
[They] are probably starting to get a sense of what the cranky old doctors mean when they talk about anti-doctor sentiment, especially when it came to the inclusion of pretty much every health degree except medicine in the Commonwealth Prac Payment scheme.
I want to talk a little bit today about why I think we keep losing. Why doctors seem to keep losing their political fights and the fights they’re forced into, and why medical students seem to be losing now.
A lot of it comes from the fact that Australians don’t see themselves represented in our profession.
They don’t identify with us the way they can identify quite easily with our nursing, pharmacy [and] allied health colleagues.
I’m from a community called Dandenong, about an hour southeast of here. [It’s a] beautiful, vibrant, multicultural place. But [it’s] also a place with real deprivation in parts, and I think it’s a place where not many doctors come from.
I recall growing up, some of the things that really angered me were the lack of access to care.
Now I understand all the levers and the politics that led to the fact that there weren’t enough training positions for junior doctors to become specialists, and there weren’t enough public outpatient jobs for them to actually serve their communities.
But at the time, all I remember is a $99 specialist fee getting in between one of my family friends and the treatment they needed. They ended up in hospital a few years later because they just couldn’t scrounge that money together.
I reflect on that today because, obviously, this year seems to be the year of specialist fees, the medical cost finder website, and so on.
It’s very important to reflect on the fact that … it’s a real struggle to reach those communities when you don’t have genuine roots in them.
The sad thing about the Commonwealth prac payment decision is that it’s a self-fulfilling prophecy.
The public and politicians have this sense that medical school is largely made up of students from wealthy backgrounds, and that they end up becoming wealthy themselves.
[That] they probably don’t need this money, do they? It could be used for better purposes.
When I really think about it, that’s the mentality that brutalises students from marginalised backgrounds who dare to try to get through medical school and serve their communities.
From my own experience, I’ve been very lucky. I got a scholarship to school [and] uni. I don’t know where I would be without those things.
We could have a whole hour debating whether Australia is really a meritocracy, but I’ll leave that topic for now.
The idea that really drove me to this position in AMSA was seeded when a professor told me that ‘if you’re working in medical school, it should only really be a couple of hours a week for pocket change. You really should [only] be doing this course if you have family support’.
For my peers and me in that room, when that professor was telling us this, we heard that message loud and clear: working-class people don’t belong in medicine.
That made my blood boil.
Medicine has come a long way in terms of gender and cultural diversity – it’s got a long way still.
But when it comes to class diversity and representing Australia’s socio-economic strata, it’s come nowhere.
The sad thing is, a few years after that, I started wondering whether he was right.
Because the position I was in is one many students have been in, where you’re working too many hours to meet placement requirements, and I’ve had to repeat placement blocks before.
But you’re also working too few hours to cover your living expenses, and I’ve been late on rent before.
That position of fearing being kicked out of the course, then being kicked out of your home, is very sincerely something that I think drives that nauseating Beyond Blue statistic that 20% of medical students have had suicidal ideation in the past 12 months.
I want you guys to take a moment to really think about that. That’s 4000 predominantly young people in this country who have thought of ending their lives in the last year.
We all know that that’s disproportionately low-income students. We know that’s disproportionately First Nation students, and disproportionately rural and regional students.
These are the students we know would actually go on to serve in the communities that need doctors the most, and yet we’re crushing them, treating them the same way we’ve treated medical students and doctors for the past 50 years, expecting them to serve our workforce in the future.
I very candidly want to reflect on the fact that keeping medical school accessible to inner-city wealthy students and then complaining when they don’t serve in areas of need is not a workforce strategy.
If medical schools were used as a transformative tool in this country, an opportunity to lift up students from more backgrounds and have them serve in places of need and lift up those communities as well, we would place medicine at the centre of Australian life and the egalitarian project this country is meant to be.
It’s such a shame that a government and a party that prides itself on egalitarianism and on the healthcare system – on Medicare itself – sees fit to sideline doctors sometimes, or to not have us at the centre of this.
When you consider Commonwealth prac payment through that lens, it becomes very hard to ignore the importance of this campaign.
And we really appreciate the AMA’s support in this, and we appreciate doctors’ support as well.
But that does need to continue, and that extends to Australians with disability as well.
One in five Australians has a disability, yet if we look around the room today, or think about our colleagues and our profession, the number of Australians with disability, and certainly physical disability, reaches a rounding error of littleness.
My vice president, Asmara Downey Twiss, is the first student at [UNSW] to study medicine in a wheelchair with a physical disability.
She actually had to rewrite the national hand hygiene guidelines because you can imagine that, doing the OSCIs, she was doing the hand hygiene, wheeling herself [back to the ‘patient’], and then [having] to do hand hygiene again.
I [jokingly] told her I resented her for that – I had to redo the modules when she reset the guidelines.
Related
When we talk about the kind of doctors and the medical profession that Australia wants and needs, it is a reflective one. It is one that embodies our communities and reflects their aspirations, fears, and hopes.
There’s a disability entry path at the University of Auckland that’s been very, very successful.
They reserve a few seats for students with disabilities, and over the years, that has created a growing community of clinicians who understand very innately the needs of a group that represents a disproportionate amount of our patients.
The same way that working class patients are disproportionately represented in hospitals.
When you think about media stories about doctors mistreating patients, and the general public’s perception of medicine as distant from them, or the hospital system as something negative for them, and the experiences and the culture that lead to that, I think that’s something the Commonwealth prac payment and the disability entry path both go a long way towards addressing.
At the end of the day, Australians deserve to have doctors from their communities that understand their needs and can treat them well.
But Australians also deserve to be able to aspire to medicine in the first place, and any Australian should be able to do that.
It’s nauseating that my peers from rural communities and I have to go back [to our communities] and tell those little boys and girls that because mum and dad don’t have enough, we don’t think it’s safe for you to do medicine.
We say that in good faith. We say that knowing that they might be forced into a diabolical choice between homelessness, dropping out, and potential suicide.
So I really do urge you all to think about these issues as you go about your day and your other incredible advocacy, [and] to remember that the face of medicine has changed significantly over the past 25 years.
But if the medical profession is to remain relevant to Australia tomorrow, at the centre of this nation’s drive for progress, we really need to think deeply about our medical schools and about making them reflect the Australian journey.
Thank you so much for your time.
This speech has been edited for length and clarity.
The 2026 AMA national conference was held at Pullman East Melbourne on 28 and 29 August.
