The government regularly tells us Australia has a shortage of skilled workers and that migration is essential because we do not have enough Australians with the qualifications needed to fill critical jobs.

But there is an important question we should be asking.

How many Australians could we train ourselves if only we gave them the opportunity?

Consider what it takes for an Australian school leaver to get into medicine.

At Monash University, the minimum ATAR required to be eligible for direct-entry medicine is 90. But meeting the minimum is a long way from receiving an offer. For standard school-leaver medicine offers in 2026, the lowest raw ATAR was 96.10. The median was 99.65.

That means half of those receiving an offer had an ATAR placing them in roughly the top 0.35 per cent of students by ATAR.

The figures demonstrate just how scarce medical places are and how many young Australians with outstanding academic results miss out.

And then Australia goes overseas to find doctors.

When Australia recruits an overseas-trained doctor, we do not require that person to have ranked in the top 0.35 per cent of their school cohort. Why have we created such a spectacularly narrow gateway for Australian students seeking the opportunity to become doctors?

We need more domestic medical places and the clinical training capacity to support them, so that highly capable Australian students have a realistic opportunity to compete for entry.

An ATAR of 90 represents roughly the top ten per cent of students by ATAR ranking. It is not credible to suggest that within this enormous pool of high-achieving students there are not thousands with the academic ability, discipline, personal qualities and determination required to become excellent doctors.

Broadening the gateway into medicine does not mean lowering the standard required to become a doctor. It means allowing more capable Australians the opportunity to prove they can meet it. They would still have to compete for entry, complete medical school and clinical training, and meet the professional standards required for registration.

The real question is why we have made the gateway so extraordinarily restrictive in the first place.

And this exposes a much larger problem with Australia's approach to universities, skills and migration.

Overseas-trained medicos make a valuable contribution to our health system, but recruiting from overseas should not be the default response to shortages we have created by constraining opportunities for Australians to acquire the qualifications we say we lack.

Skilled migration should complement the development of Australian skills, not be a substitute for it.

And “full-fee” international students should not automatically be confused with “full-cost” students.

Medical education depends on hospitals, clinical placements, doctors and other health professionals who supervise and teach students, as well as health infrastructure substantially funded by Australian taxpayers.

If Australian taxpayers help provide the infrastructure that makes medical education possible, it is reasonable to ask whether Australian students are being given sufficient opportunity to access it.

An Australian higher education system receiving billions of dollars in public support should play a central role in developing Australia's own human capital. Yet we have constructed a system in which highly capable young Australians are turned away from courses leading to occupations we classify as being in shortage, and then use migration to help fill those shortages.

Importing a doctor may help solve an immediate workforce problem, but it is no substitute for ensuring capable Australians have sufficient opportunities to become doctors themselves.

Before we import more medicos from overseas, we should begin by looking at the extraordinary pool of talent already sitting right in front of us in Australian classrooms.