Medicine for Mature Age Students

Historically, entrance to medical school in Australia has been dominated by young school-leavers, typically aged 18–19 years – and this is also true in the United Kingdom and North America. However, since the 1990s, graduate entry became much more common in Australia, influenced by a rapid expansion of medical education provision, concurrent developments in curricula and models of delivery, as well as policy initiatives to widen access to medicine. As it stands now, graduate entry into medical programmes in Australia, which began in the early 1990s, has grown substantially in the three decades since and is now available at 13 of the nation’s medical schools, and it has become much more accessible to mature age medical students.

But what is a ‘mature-age’ student? This is a very loaded question – and the technical definition, as defined by Mathers and Parry (2010), is that mature age medical students are those at the age of 21 years or over – i.e. not in the first two-or-so years outside of high school. I have found in my medical school experience, however, that a “mature medical student” may be those who are not only the age of 25-or-so, but also those who have additional responsibilities outside of medical school. A classic study by Harth, Biggs and Thong (1990) shows that mature-age entrants are usually some 7 years older, are more likely to come from public (state) schools and less likely to have parents in professional/ technical occupations – and thus from working class backgrounds.

This blog will seek to give some helpful advice and overview of the unique struggle of mature medical students through the medical school program, and beyond!

In nearly every class I teach here at GradReady, I hear of students being ashamed or frightened at the prospect of starting a medical degree at a more mature age than what those going straight from high school would be. Although being on the other side of 20 may present some unique life challenges in preparing for the GAMSAT exam and studying medicine, this article will seek to elucidate some of the incredibly positive points of medical school for mature age students (and why, if you’re not a mature student, you should look forward to having them in your tutorials!).

The mature age medical student presents the undergraduate (or, non-mature student, if you pardon the cheek!) with a quizzical situation, and someone that they may not be able to relate to. For many undergraduate students in medicine, they quite often will hit the town all-too-frequently, with the baggy rave pants and accompanying fluro sunglasses for the local dark and questionable club on a Saturday night, they might not have to work, being supported by parents, and have little-to-no-responsibilities outside of their study. However, this is not the case for mature candidates. They may have other responsibilities, such as full-time employment, family, or serious relationships. We can’t be 19 forever, sadly. And indeed, through this rave-haze of life prior to your maturation into an adult, many of us don’t consider medicine as a career, or we have more important issues (as aforementioned!) to attend to in life rather than get stuck in an intense course for four years.

Medical school is a mammoth task and entering it is not only a significant decision but requires a Herculean effort. With no disrespect at all to our younger colleagues, but I could never have made the decision to try to get into medical school at 18 or 19 years of age, and to be quite honest, it’s probably for the best that I didn’t! As a study by Mathers and Parry (2010) demonstrates, mature aged candidates' pathways to medicine are a bit more risky, inclusive of substantial financial resources, moving family away from established homes and social networks, and a need for students to undergo substantial identity shifts that enable them, firstly, to contemplate medicine, and then to make successful transitions to medical courses. Geography is key and many older mature students have a strong preference for local medical schools as a result of personal circumstances. However, a need to establish ‘fit’ between institution and individual is also evident, with elements of identity (e.g. age, class) playing a role in such judgements. Indeed, many mature aged students, and this accords with my own personal experience, have working class backgrounds, and have had to struggle to even consider getting into medical school. For me, it was never even a possibility that was ever remotely discussed at high school – people like me, with a working class background, just weren’t ever doctors. It can't be denied that studying medicine isn't cheap. Check out our article on how much does it cost to study medicine if you want to know more.

However, once mature students get into medical school, there is research demonstrating their proficiency. Puddey, Mercer and Carr (2019), surveying a huge number of graduate and undergraduate students, there were generally higher mean examination scores for mature students in the first two years at medical school, with not much difference after. Mature students were also less likely to have impeded progress during the course. However, if mature students did have a leave of absence, it was more likely for medical or financial / employment reasons, as compared to undergraduate students. Following graduation, however, most of the literature demonstrates no differences between mature and undergraduate practitioners in research outcomes, career positions held by clinicians, choice of family practice or other specialty, and practice location (rural or urban) (Rolfe, Ringland and Pearson, 2004).

This research is very reflective of my own experiences in medical school – our mature peers have a host of other skills and coping mechanisms that they can employ with full effect in medical school to stave off starvation, deal exquisitely with stress, and effectively time-manage. They are quite often far more empathetic and able to communicate effectively with others. Indeed, I have long believed that they are by far and away the most effective medical students. However, for older students, the first 6 months or so of medical school are certainly difficult. The adjustment back to full-time study must be made, along with the associated juggling at home with kids, debt, and a partner, and so this is a challenging time. However, time and time again I have witnessed our colleagues triumphing over this initial hurdle and being the much better students for doing so.

Not only do mature age medical students bring a whole host of life experiences to medical school, along with plenty of life advice for their younger peers, they often develop a fierce work-rate due to the plethora of extra work they’ve had to put into the GAMSAT Exam to get a good score and into the first part of medical school to catch up to their younger colleagues, who have an extensive background in science, whereas the mature age students may be preparing for the GAMSAT Exam with a non-science background. I am often overjoyed to find a mature student in my PBL group, because more than likely, their work will be simple, yet thorough, and they will usually be a level head in the stressful environment of biweekly group work. As a generalisation, mature students are much, much better with patients. They have real world experiences, which helps them communicate effectively with a fellow human being who may be in a very stressful situation, or who is very unwell. These students are generally more empathetic, and able to connect more with patients, doctors, and other members of the health care team.

Overall, although mature age medical students may face additional life questions, such as when to have kids, or struggle to find time with their long-term partner, they are an invaluable part of medical school, and as far as medical school entry requirements go, age shouldn't be an issue. I want to overwhelmingly assure our mature colleagues that they will be champions of medical training, and be extremely valuable to other students and to the general medical and health care fraternity. So I beg you all to stop comparing yourself to these ‘young whipper-snappers’ who have barely escaped high school, and to think about all of the positive things you can bring to medical school, and the huge amount of qualities that you possess that will ultimately make you extremely successful doctors!

The first and one of the most important steps to studying medicine is to prepare for the GAMSAT exam. If you come from a non-science background, check out our guides for preparing for GAMSAT Biology, Chemistry, and Physics.