Doctors and medical academics have warned that top-up fees could drive away the medical students needed by the National Health Service to meet its recruitment targets.
The white paper made no commitment to rumoured fee remissions for public-sector workers.
Colin Smith, chairman of the British Medical Association's medical academic staff committee, said: "Universities with medical schools derive about one-third of their income from medical faculties. If universities are allowed to set their own fees, medicine is likely to be hardest hit."
Michael Powell, executive secretary of the Council of Heads of Medical Schools, said: "Medical schools are in Russell Group universities that are clearly going to want to charge appropriate fees for their universities.
[They] are concerned to widen participation, but it will be up to the government to make the necessary adjustments to ensure that access is not hit."
Nursing academics are also concerned about top-up fees. Nursing students on diploma and degree courses do not pay fees and are entitled to bursaries.