US or Canada?

So I feel like my situation is fairly unique, which unfortunately leaves me with few people where I can get advice from. So I hope someone is able to help me. I am a high school junior student living in Canada. The thing is however, I have both an American and Canadian citizenship. I’ve known for a long time I wanted to go to medical school and I’m determined to make it happen. My preference is to live in the US when I’m older, but for me to practice their I’d need to go to medical school there. I’ve heard that doing your pre-med in Canada puts me as a “secondary applicant” in terms of applying to US med schools. The downside to going to the US for my pre-med would be that it is simply so much more expensive than schooling in Canada.

So my question is, what is my course to achieve my goal? Would I really lose a competitive edge if I went to a Canadian school, as I still would be an American citizen? Or is the gamble simply too great and I should go to an American undergrad?

Have you considered attending a medical school in Canada ?

The issue with that is there are much fewer medical schools in Canada compared to the US, so difficulty-wise it wouldn’t be easy (not that going to the US would’ve been easy anyway). Also, I want to practice/live in the US.

You absolutely do not have to go to med school in the US in order to practice in the US. There are plenty of Canadian trained doctors in the US.

“but for me to practice their I’d need to go to medical school there.”

As others have pointed out, you can attend medical school in Canada and then do your residency in the US. I know someone who did exactly that, and have heard of multiple other cases.

Medical school admissions is difficult regardless of whether you are in the US or in Canada.

We are in a similar position, living in the US but with me and both daughters having dual citizenship. One is currently at university in Canada. If you include four years of undergrad plus the cost of medical school, the difference in cost is enormous. If you have $500,000 in your college fund then you can afford to attend undergrad and medical school in the US. However, most don’t have a college fund this large and the average medical school debt down here is very scary, even for doctors. Once you are half way though medical school, pretty much your only chance to pay off the debt is to become a doctor or a rock star.

Another advantage of attending university in Canada is that admissions is predictable – if you have the grades and test scores then you are pretty much in.

My best guess is that the gamble of taking on US sized student debt is quite a bit worse than the gamble of attending university and medical school in Canada intending to move to the US for your residency.

The value-for-money of attending a Canadian university for Canadians is excellent (your tax dollars at work).

I hear different things about how easy/hard it is to get into med school in Canada. I don’t know exactly how the numbers compare to US MD programs, but every school posts their admission stats. For what it’s worth, I have 2 friends from my undergrad days in Canada who applied broadly to Med School. Both were Canadian only, and were rejected from every Canadian school. One got admitted to UCSF and the other got into CWRU, but it was too expensive for them to attend, so both reapplied to Canadian schools the next year and got in.

Canadian med schools seem favorable to older applicants with work/life experience. Most of my college & high school friends took at least 1 year off for work or grad school before applying to med school.

What are the criteria for getting a job as a doctor in the US? Does school matter? Will I be able to get a job as a doctor if I have a Canadian MD but have a US citizenship?

The US and Canada have a harmonized medical education system. Graduates of Canadian medical schools are not considered “foreign” in obtaining residencies in the US. Also all US medical schools will accept prereqs done at a Canadian university. That is not the case for other countries. All Canadian medical schools are accredited by LCME, the American accrediting board.

As a US citizen living in Canada and graduating from a Canadian university the only drawback would be that you would not be in state for any public medical school in the US.

An MD degree and completing a residency.

Not true. You would only be disadvantaged if you were not a US citizen.

You need a valid medical licensed issued by the state in which you will be working.

To get a medical license, you need to be able to prove you have graduated from a US or Canadian medical school and have completed a minimum of 1-2 years (exact length of time varies by state) of accredited residency training in the US. Canadian residency training may or may not be acceptable depending on state regulations.

The reality, however, is if you want to be hired as a physician in the US, you need to hold board certification/board eligibility in your specialty. This requires completing a US residency and sitting for the US specialty board exams.

Canadian med grads are eligible to enter the NRMP if they have taken and passed the USMLE series (Step 1, Step 2CE, Step 2CK). You will need to study for the USMLEs on your own since the Canadian med schools require and prepare their students to take the MCCEE exams instead.

Graduates of Canadian residencies may be eligible to sit for US board exams if the appropriate accrediting board for their specialty determines their Canadian residency training is equivalent to the training offered by a US residency program. This is not automatic. Certain specialties–EM and FM in particular–have major issues due to the differing lengths of training in the US and Canada.

Yes, especially if you complete a US residency, you will no issues at all.

Gaining admission to a Canadian med school is much more difficult than it is in the US in terms of sheer numbers–

https://studentaffairs.jhu.edu/preprofadvising/pre-medhealth/applicants/special-applicant-groups/canadian-applicants/

For a comparison, there were just over 53,000 applicants to US allopathic med schools in 2017-18 and 21,000 matriculants.

https://www.aamc.org/download/321472/data/factstablea8.pdf
https://www.aamc.org/download/321462/data/factstablea4.pdf

“What are the criteria for getting a job as a doctor in the US? Does school matter?”

The US and Canada have a shared system for accrediting medical schools. As such, in order to be a doctor in the US, you are better off if you attend medical school in either the US or in Canada. There are a few medical schools in other countries which are also accredited by the US/Canada system, but I don’t know much about them. I am pretty sure that every medical school in the US and in Canada is considered to be very good or excellent.

To be a doctor in the US, you need to do your residency in the US. As such you could do both undergrad and medical school in Canada, but when you are getting close to graduating from medical school you would sign up to do your residency in the US.

If you are still in high school, and are seriously considering medical school, then you should be aware of two additional points. One is that when applying to medical schools you will need to have a lot of experience volunteering or otherwise working in a medical environment. If you go to a hospital it is not unusual to see young people volunteering in a variety of roles. Some of them will be volunteering to gain hours for the purpose of eventually applying to medical schools.

The other issue is that premed classes are very tough, and you need a high GPA to have a good chance of admissions to medical school. Premed is not a major, but there are a set of premed classes that you need to take to apply to medical school. The majority of students who arrive for their first year of university intending to be premed eventually give up on applying to medical schools. The majority of students who do graduate having completed premed requirements and apply to medical schools never get in anywhere. As such you would be well advised to have something else in mind as a possible backup in case medical school does not work out. Avoiding debt for undergrad will also take some pressure off in terms of figuring out what you want to do next (whether it be medical school or something else).

Neither of my daughters is currently premed. However, both have majors that overlap quite a bit with premed requirements and as such both have taken or are taking classes that contain many premed students. It is not unusual to hear of exams where the class average on the exam is 50 or less out of 100. The students who get 80’s or higher on these tests are the ones that have a realistic chance of going on to medical school.

@WayOutWestMom: As always, great posts. I do not, however, understand the significance of “excluding the University of Toronto and Western University” comment.

@Publisher

Those 2 medical schools did not report their application or enrollment numbers to the [Canadian] national commission on medical school admission.

Per Western’s website, there were 2500 applicants for med school, 171 were accepted. Admission is only open to residents of SW Ontario.

UToronto FOM, per website data, had 3200+ applicants and accepted 259.

@DadTwoGirls

This simply isn’t true. The LCME does NOT accredit any medical schools located outside of the US and Canada.

http://lcme.org/directory/

Grads of non-LCME accredited programs are considered IMGs (International Medical Graduates) and must apply for US residencies through the ECFMG.

@WayOutWestMom So would all Canadian and American universities/med schools be accredited by the LCME? Also, does this mean if I went to a Canadian medical school and applied for US residency (reminder, I have US citizenship as well), I would not be considered an IMG?

If there is no extra difficulty for me to do Canadian undergrad and go to an American med school, is it extra difficult for me to go to a Canadian med school to American residency?

Essentially, I’m asking would it be harder for me to get an American residency if I went to a Canadian med school?

Yes, all Canadian and US medical schools are LCME accredited as I stated above. And as I also posted above your only drawback in US medical school admission is that you will not have an in state advantage at public medical schools. You also cannot establish in state residency by attending college in that state in most states.

@TomSrOfBoston Could you elaborate when you say I cannot establish in-state residency by attending college in that state? Are you saying I’ll be in-state by the time med school is over or what?

When I say residency I’m referring to the training one would get after medical school. Is there such a thing as in-state/out of state residency (the medical training)?

Basically, I’m asking if I go to a Canadian undergrad + med school, will I have trouble getting an American residency (medical training)? Would the American residency make me qualified to practice in the States or would I need the American medical school as well?

If you go to a Canadian Medical School and complete the appropriate residency then your skills will also be accepted at par in the US, though you do have to write the US Boards. It can be done, but is a bit trickier, to do your Canadian medical school degree, then a US residency. Depending on what your specialty is, the amount of years to complete residency can vary from country to country, i.e. GP is 2 years in Canada, 3 in US, Internal Med 4 years in Canada, 3 years in US, etc…

You can get very good medical training in Canada, that will be accepted at par with training by the US medical establishment. In most cases, the tuition costs in Canada are a fraction of what they are in the US. Unless cost is not an issue, then it seems like kind of a no brainer to go to a Canadian school, then settle in the US after your training is done, if you are determined to take that course.

Two meanings of residency.

Most if not all state medical schools in the US give preference in admission or reserve most seats for applicants who are residents of that state as they define it.

A medical residency is what you do after receiving your MD degree and has nothing to do with being in state or out of state.

So would that mean I would still be open to private medical schools in the US?

I want to know if this is a feasible plan for someone of dual citizenship:

Undergrad in Canada (cheaper)
Medical School in Canada (cheaper)
Medical residency in the US (So I can practice there)

Would I be allowed to immediately practice medicine in the US if I had an American residency?