The Scottish Executive may charge English students a premium to study medicine north of the border in a bid to boost recruitment to Scotland's National Health Service by training more native doctors.
Jim Wallace, Enterprise and Lifelong Learning minister, flagged up the prospect when announcing plans to "protect" Scottish students from the consequences of top-up fees south of the border.
Last week Mr Wallace announced that from 2006, students from elsewhere in the UK would be charged about £500 to £700 a year on top of the basic tuition fee of £1,125 a year they currently pay in Scotland.
The move is designed to protect Scottish universities from an influx of "fee refugees" from England. Scots studying north of the border will continue to pay a £2,030 contribution after graduating.
Mr Wallace said the recent medical review chaired by Sir Kenneth Calman, vice-chancellor of Durham University and former government Chief Medical Officer, highlighted the fact that about half the medical students north of the border came from outside Scotland and that many English students move south after qualifying.
"(Sir Kenneth) noted that the changes in fee levels in England might make the difficulty of recruiting sufficient numbers of graduates to the NHS in Scotland worse," Mr Wallace said. "Therefore, we will examine the case for setting, exceptionally, a separate higher flat-rate fee for medicine."
Rami Okasha, president of the National Union of Students Scotland, said:
"Our position is very clear. We don't believe the student financial support system should rectify the failings of the NHS, which needs to look at why it can't recruit people.
"The principle it would establish is that for popular courses, it's OK to charge more. Access should always be on the ability to learn and not the ability to pay."
Fees have been axed for Scottish students and entrants from elsewhere in the European Union.
Mr Wallace said that under EU law, other EU students must be treated the same as local students in a region, but this did not apply to other students within a member state.
The Scottish Executive plans to abolish the Quigley agreement, under which the Executive pays fourth-year fees for students from elsewhere in the UK who study in Scotland.
It also aims to give Scottish students moving south a subsidised loan to cover variable fees up to £3,000.