It is well recognized that students from refugee backgrounds are typically predisposed to social, economic, and educational disadvantage. These layers of disadvantage can negatively impact upon higher education participation, not only in undergraduate, but also postgraduate education. This is even more pronounced in high stakes courses (e.g., medicine), where competition for entry is fierce. Pursuing medicine is arguably a pipedream for most immigrants from refugee backgrounds.

We incorporate a retrospective narrative based on the first author’s experience of a major policy change. Using historical correspondence records, the authors present the story of an unsuccessful applicant with a refugee background, who questioned why she was denied entrance into medicine. Her appeal triggered the establishment of a refugee subquota into graduate entry medicine. This chapter describes the antecedents, development, and subsequent successful implementation of this policy initiative. The broader implications for the healthcare system, patient care, and medical education are discussed. This chapter concludes by urging higher education institutions to review their policies so that students with a refugee background are fairly represented across all courses and careers, providing them with the opportunity to convert their pipedreams into possibilities.