When one of Lisa Ross's three daughters fell ill, it took three weeks for her to secure an appointment with a GP within their regional town in Western Victoria.
It was then that the Horsham physiotherapist decided to return to university to study medicine.
The 40-year-old enrolled in Deakin University and moved her family to Geelong, but it was in the second year of her degree that the stress of juggling a full-time study load, along with family life and a mortgage, reached breaking point.
"I actually had to make the decision for [the mental health of our family] and lifestyle and all of those reasons, to pause my medical studies for a year," Ms Ross said.
She's returned to university this year, but due to only being able to work a few hours a week, she feels a huge burden has been placed on her family.
"We're having to decide between the kids doing swimming lessons or not doing swimming lessons," Ms Ross said.
"I really feel like it's inequitable and that's not just for mums but for anyone who has a financial burden or has a career … having to do one or the other is very tricky."
Ms Ross has written to the dean at her medical school, calling for the university to offer students the option to study medicine part-time.
There are currently no medical schools in Australia that offer part-time study options.
"I don't want other parents to not study medicine for their communities because of those challenges," Ms Ross said.
"If I was studying part-time, I could work a day or two a week, I could be the mum that I want to be, I'd come out at the end, and I wouldn't be burnt out.
"And it might not be the exodus of burnt-out doctors because we'd come out of it well, intact and healthy."
Around the world, most medical degrees are only offered full-time, but some universities are beginning to pilot part-time programs.
Earlier this month, the University of Edinburgh graduated its first cohort of part-time medical students — a first for the United Kingdom.
Finding a model to suit all medical schools
Medical Deans Australia and New Zealand president Stuart Carney said Australian medical schools recognised the need for more flexible study options and were investigating ways to implement a part-time program.
He said the difficulty was in finding a method that would suit all 22 Australian medical schools, as programs differ between universities.
"We've established a working party which is reviewing the evidence and identifying what's working well and what's not working quite so well in other countries," Professor Carney said.
"Some of that relates to how we configure the early stages of the program, particularly classroom-based opportunities, with students spending perhaps half the week at university [rather than every day of the week]."
Government working to understand the barriers
A spokesperson for the Department of Education said the federal government did not restrict medical students from studying part-time.
"The government is working with the university sector to better understand the barriers to medical students accessing part-time study," the spokesperson said.
"Additional medical students accessing part-time study options would not change how the government allocates medical Commonwealth Supported Places (CSP) to higher education providers."
Deakin University Doctor of Medicine course director Karen D'Souza said the university would consider a part-time option once the federal government reviewed the funding model.
She said under the current system, each medical school was subject to an agreed government quota, relating to the number of graduating medical students on a CSP each year.
"When students change to part-time studies, this means that the medical school will graduate fewer students in the graduating cohort and fall short of their agreed quota of graduates to take up positions as employed junior doctors," Dr D'Souza said.
Professor Carney said the government needed to work with universities to ensure they were not penalised for allowing some medical students to study part-time.
"At the moment, we are only able to accommodate those individuals whose personal circumstances can enable them to study full-time," he said.
"A lot of talented Australians out there — be it as a consequence of carer responsibilities, childcare responsibilities, or financial situation — can't take advantage of full-time education offerings."
Financial worries affecting full-time students
Nearly 90 per cent of students studying the Doctor of Medicine reported financial precarity was having a negative impact on their learning and wellbeing, according to a survey of 200 medical students at Deakin University.
A further 36 per cent of students surveyed reported that caring responsibilities also affected them negatively.
In a separate survey, which is continuing to collect data but has so far collected responses from more than 400 medical students across Australia, more than 75 per cent of respondents reported negative impacts of financial hardship on their learning and wellbeing.
Med students not eligible for payment
Medical students have also been excluded from the Commonwealth Prac Payment, which allows nursing, midwifery, teaching, and social work students to claim a weekly payment of $319.50 during their mandatory placements.
Medical Deans AUSNZ and the Australian Medical Students Association are two groups that have been advocating for medical students to be made eligible.
AMSA president Melody Ahfock said part-time study was part of the solution to diversify the medical workforce and to support medical students who were struggling, but it needed to be implemented in a way that considered students and the broader healthcare system.
"The cohort of students that would likely benefit from part-time and flexible study options are probably also part of the cohort that would benefit from the Commonwealth Prac Payment," Ms Ahfock said.
"It's absolutely part of the solution for addressing placement poverty for these students who are at a disadvantage.
"Medical students have been calling for increases in the flexibility of medical school education, acknowledging that medical school is notoriously laborious as well as financially draining."
A spokesperson for the federal Department of Education said the Australian Universities Accord recommended the government fund placements for nursing, care, and teaching professions, and funding by employers for other fields.
"The government will continue to work with tertiary education providers, state and territory governments, industry, business, and unions to consider further support for those experiencing financial hardship and placement poverty caused by mandatory unpaid placements in other courses in due course," the spokesperson said.
Flexible learning begins at some unis
Some universities have already made significant adjustments to their medical degrees to allow for more flexible learning.
Deakin University has streamlined the timetable for students in their first two years, so that classes are spread over three and a half days a week, rather than five.
The university also allows students to live-stream or watch pre-recorded lectures, as well as complete some learning sessions online.
Medical Deans AUSNZ's Stuart Carney said it was vital to promote flexible learning to support mature-aged students, many of whom become GPs.
Older medical graduates and those with dependent children are substantially more likely to nominate general practice as their preferred career path, according to an analysis of the Medical Schools Outcome Database.
Graduates aged 35 to 39 are twice as likely to prefer a career in general practice compared to the overall respondent average.
Medical students with dependent children are also more likely to become GPs.
Last year, 37 per cent of respondents with children chose general practice as their preferred specialty compared to 15 per cent of the general cohort.
Hope for future students
Even though the change is unlikely to occur during her degree, medical student Lisa Ross hopes future medical students will benefit from more flexible learning.
She said mature-aged students like herself brought a breadth of life experience to medicine and a fresh perspective.
"I want to come out the other end with my family intact, I want to be a great doctor, I want to be a GP for regional communities," Ms Ross said.
"I want to live those values, and I want to start living them as a student as well."
