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However, this balance is under threat in the United Kingdom and the United States, where the cost and duration of medical education are increasingly forming a barrier for students from lower socioeconomic backgrounds. In the US, 60 per cent of medical students come from families in the top income bracket; becoming an MD is apparently beyond the reach of most middle and working class families. And no wonder! A US medical education costs about US$120 000 in public medical schools and US$225 000 in private schools. With Australia’s recent move towards full-fee-paying medical students, we may well wonder whether we are set to mimic the American way.