A step-by-step guide to mastering the U.S. medical school admissions process, plus a list of American medical schools that accept Canadian students
Many aspiring Canadian doctors are increasingly moving across the border to get their medical degrees in the United States. Some are hungry for international experience. Some just want to get away from home. And some are put off by the extreme competitiveness of the Canadian school admissions process—where over 81 percent of applicants were rejected from every institution to which they applied.
You might be considering joining the great migration—but are probably beset with all sorts of questions.
What’s different about the American medical school admissions process, compared to the one in Canada? Which US admissions committees are most Canadian friendly? How expensive is tuition at US medical schools? And will I even be able to find a residency program—whether at home or in the United States—if I get my degree abroad? Can getting a medical degree in the US help me become a citizen?
The goal of this guide is to answer those questions, and more—providing all the information you need to decide whether an American degree is right for you, and a step-by-step plan for how to ace the admissions process.
Part 1: Considerations for Canadians applying to US medical schools
Which American medical schools accept Canadian students?
For all the uproar over rejection rates at Canadian medical schools, the US admissions process is hardly a cinch either—with only 41 percent of all applicants to American institutions matriculating in the 2018-2019 academic year. Just as in Canada, doctor shortages in the United States haven’t fully translated into higher medical school admissions rates because the demand among students to become doctors has grown as quickly as the need to train new ones.
This has made admissions particularly difficult for international applicants, only 18 percent of whom were accepted last year. Most medical schools get state funding, and governments typically want their money to go to American students who are more likely to stick around and deal with the doctor shortage. Many schools, such as Albany Medical College and the Chicago Medical School, won’t even allow international students to apply.
Canadians, however, have a leg up on other foreign applicants. Similarities in education and medical styles mean Canadians citizens who did their undergrad degrees at home have almost no trouble getting their coursework accepted and, in the case of so-called “Canadian friendly” schools, are sometimes considered in the same applicant pile as out-of-state US citizens.
Below is a list of Canadian friendly institutions, which we compiled by looking through AAMC’s Medical School Admissions Requirements (MSAR).
List of Canadian friendly American medical schools
(Note: For the purposes of this list, "Canadian friendly" schools are the institutions that have formally declared to the AAMC that they consider Canadian applicants in the same pile as out-of-state US applicants, rather than as international applicants.
It's probable that if you ask schools that were not included in the list about their treatment of Canadians, you would find a few that would express generosity towards Canadians up to the point of being "Canadian friendly" without having the formal designation. For the same reason, I wouldn't just assume that non-Canadian friendly schools would have "drastically lower" admissions rates for Canadians; it's just a title. So you should go ahead and ask other schools how they feel about Canadians. You should use the "Canadian friendly" list not to rule schools out, but to find new ones.)
How much do US medical schools cost for Canadian students?
Getting your MD in the US will, inevitably, cost you much more than it would in Canada. Tuition rates are higher—at 72,400 CAD a year on average for Canadian students in the United States, compared to around 17,600 CAD a year back home.
Plus, Canadian students are typically not eligible for scholarships or financial aid, which are often government funded and reserved for American students (though affluent, privately-funded institutions, such as Yale and Harvard, do have aid available for international students).
And since many schools—such as the New York Medical College—require you to prove you can pay your way through every year of the program at the time of admission, holding the money in escrow until you finish your degree, most students will have to apply for a hefty student loan from the Canadian government, or a line of credit from a bank.
That’s about 290,000 CAD, up front. And interest on those loans can accrue quickly, especially if you opt for a line of credit (perhaps because your provincial government student loan program won’t foot the bill for the program you want).
So, assuming you’ll have little-to-no income during the four years of your MD, and only around 75,000 CAD a year during your 3-5 year residency, it’ll probably take you much longer to repay those loans compared to a Canadian degree, which would only cost around 70,400 CAD in total.
So before you make your decision, contact your provincial student loan office, your local banks, and the financial aid offices at your chosen schools, to see what they might be able to offer you. You’ll have a better estimate of the costs, and more clarity to decide what makes the most sense for you.
Can I bring my American MD back home for Canadian residences? Can I stay in the U.S. for my residency?
Your chances of matching to a residency program both at home and abroad will decrease if you decide to get an American medical degree.
In Canada, you’ll have to deal with a residency matching process that heavily favors graduates of Canadian medical schools. In 2018, 91.6 percent of Canadian citizens who graduated from a Canadian medical school successfully matched, compared to 58.5 percent of US medical school graduates (USGs). Some Canadian residency programs don’t even consider USGs, whereas others—such as the University of Toronto and McMaster University—place limits on such applicants.
This is in part because of the lobbying efforts of the Association of Faculties of Medicine of Canada, who want their own students filling up those coveted residency spots. (Officially, they justify their stance by claiming their curricula better prepare graduates to deal with Canadian medicine, but self-interest likely plays a role as well. They need to assure their students they’ll get a return on their tuition fees.)
In the US residency matching system, having a US medical degree will be an advantage, but you will be hurt by a preference for US citizens and permanent residents. Though we can’t quite know the extent of this preference we know it exists because the number of residency programs to which a US-trained Canadian can apply is restricted to those that are willing to offer them a J-1 or H-1B visa.
And while Canadians have, historically, had an easier time of getting visas than applicants from other countries, the process is not immune to politics. You can find a guide to the visa requirements for Canadian applicants here.
So if you’re deciding between Canadian and American degrees, a Canadian MD will maximize your chances of landing residency in Canada. You’ll still have the option of relocating to the United States after your residency—though you’d still have to find an employer, pass the United States Medical Licensing Exam (USMLE), and get through the bureaucratic slog of attaining a US H1-B or permanent residency.
If you’re deciding between doing your degree in the US and another foreign country—such as Ireland or Australia—however, a US degree is far safer if you want to do your residency in North America. Those nations’ MD programs train their students based on standards of local practice, which are unlike those of the United States and Canada (which are, by contrast, quite similar). As a result International Medical Graduates (IMGs) are less prepared for the USMLE and the Medical Council of Canada Evaluating Examination.
Match rates for IMGs are also far lower in both systems, clocking 56.5 percent in the United States and 22.6 percent in Canada in 2018.
Part 2: Getting into US medical schools as a Canadian applicant
You might have read online that US medical school admissions are more “holistic” than admissions in Canada, putting greater weight on life experience and personal context than GPA and test scores. But as we wrote in our guide to Canadian medical school admissions, the goals of the two processes aren’t necessarily that different.
Both cultures weigh GPA quite heavily, the average GPA of successful applicants to US medical schools hovering around 3.7. (US schools also tend to be more concerned about the MCAT, since educational standards vary more across the country than in Canada, with the average score of successful applicants to the American system being around 511.)
Yet both are also very aware—given their medical shortfalls—that most of their graduates will enter practice straightaway. They therefore tend to accept those applicants they think are most likely to make good doctors, rather than simply choosing brainy types who might, say, thrive in a PhD.
That means accepting students with experience in the medical system and personal traits such as empathy, strong listening skills, and the desire to address public health issues.
It also means accepting students who can add diversity to their student body—bringing an awareness of and commitment to the unique medical needs and histories of communities that are not white, urban, or affluent.
The difference between the two systems lies less in those final goals than in the metrics each nation uses to measure how well an applicant embodies those ideal-doctor traits.
Whereas personal statements, secondary essay questions and panel-style interviews don’t carry as much weight in the Canadian system, most American institutions stand by them. And each of those metrics is designed to let you highlight a different aspect of how you would make a good doctor.
So here’s how you can ace each of those metrics and the American medical school admissions process in general, step by step.
Step 1: Make a list of schools to apply to (1-2 years before deadline)
Canada has only 17 medical schools. The United States has 141. And trying to apply to too many of these institutions—along with whatever Canadian schools you might be considering—can severely harm your application, draining your effort and motivation to tear through your secondary essay questions as much as your bank account.
So put together a list of 15-25 schools, according to the following breakdown, to make sure your admissions target list has the right balance of competitiveness and restraint.
Recommended reading: Where to Apply to Medical School to Maximize Admissions Odds
Step 2: Check the US medical school admissions deadlines and requirements (1-2 years before deadline)
Most US medical schools use the American Medical School Application Service (AMCAS) for their admissions process. (Notable exception: schools in Texas have their own application service.) They’ll typically require you to submit:
An undergraduate transcript from an accredited Canadian or US post-secondary institution, showing you have completed certain academic prerequisites
A 5,300 character personal statement
2-3 reference letters
A panel-style interview
As in Canadian admissions, academic prerequisites will consist of a variety of science courses in biology, chemistry and the like, but are more likely to include courses in the humanities, which schools such as Duke demand. Furthermore, while most American schools will accept Canadian coursework for prerequisite fulfillment with no questions asked, you might want to call the admissions officers at your chosen schools and ask about their policies, just to be safe.
The AMCAS process usually revolves around the following dates:
End of May, applications open for submission
End of June, application deadline
Early-mid July, secondary application questions released
Mid-October-April 1st, decisions released
You should therefore:
Make sure that you’ve fulfilled or will fulfill prerequisites for chosen programs, one year before deadline
Start arranging reference letters, six months before deadline
Take the MCAT three months before deadline, at the latest
Recommended reading: The Ideal Medical School Application Timeline
Step 3: Beef up your extracurriculars (1-2 years before deadline)
A typical Canadian student’s application for US medical school will look a lot like their American counterpart’s—made up of research, leadership and volunteering experiences, usually in fields connected to the medical system.
Elsewhere, we’ve written about how these activities, while necessary, are also common enough that they won’t really help you stand out from other applicants. A well-crafted personal statement, filled with genuine reflection on those experiences (or perhaps even more personal ones), is to some extent more important.
But some Canadians nevertheless feel they’re at a disadvantage in the US medical school admissions process with regards to their extracurriculars, for a few reasons.
First, legal restrictions in Canada often limit students’ opportunities to get clinical experience before applying for medical schools, which admissions committees often look at to see whether a student has had a chance to observe what it means to be a good physician. Shadowing opportunities, for example, are far rarer and more limited in scope.
Second, Canadian applicants’ extracurriculars and experiences are, for obvious reasons, less likely to speak to the history, practices and problems of US healthcare—invaluable, in a system where universities are expected to train doctors for local practice.
Some try to address this by going to the US or some other foreign country and, for example, trying to volunteer at private hospital—showing familiarity with a format far different from Canada’s public, single-payer system.
But a better approach may be to do things in your local community which speak to transnational problems. Try to volunteer with groups tackling healthcare issues ranging from nutritional health to geriatric care where you live, and do some research to see whether those issues have echoes in the areas where your preferred US schools are located.
Vancouver’s safe-injection sites, for example—which provide drug users with clean needles, lowering overdose and HIV transmission rates—have been cited by numerous groups in the United States as a model to be followed as the country faces its opioid epidemic. American schools located in areas with similar problems to Vancouver would be very interested to hear from a student who’s volunteered at those sites.
They’d also be interested to hear from a student who has learned about mental health by counseling a friend over a number of years, or about the ways abuse can inhibit access to medical care by working at a women’s or senior’s center. Those activities might be less spectacular, but they’re important and universal issues nonetheless. What’s key is that you do some reading and learn how you can connect your local experiences to a US context. (We’ll talk about how you can make these connections without sounding presumptuous, later on.)
Step 4: Write your personal statement (2-3 months before deadline)
The personal statement is your chance to show admissions committees how your story sets you up to be a fantastic physician—how it helped you understand the importance of empathy and listening, or gave you an intriguing perspective on an important medical issue. This is exactly why the AMCAS personal statement prompt is so vague, asking applicants to “Use the space provided to explain why you want to go to medical school” in up to 5,300 characters.
Forgettable personal statements are the main reason qualified applicants are sometimes rejected from every medical school they’ve applied to: essays that only discuss accomplishments, rather than lessons, or that hang on clichés such as how being a doctor is a sacred honor, or which talk about experiences without relating them to personal qualities or principles.
Our comprehensive guide to the medical school personal statement is the best place to learn how to craft a glittering essay—so be sure to read through it. One piece of advice specific to Canadian students, however, is to highlight experiences that relate, in some way, to an American context. Talking about the integration of secessionist Quebec into the Canadian medical system, for example, might be too niche. But discussing distrust of medical professionals among some immigrant communities is far more relatable.
Be careful, however, not to hammer on the similarities between Canada and the United States, because that’ll feel like pandering, as we see with this example:
When I saw the scenes in Flint, Michigan, I was shocked but not surprised. As a Canadian with family members from the far north of my province, I knew our government had neglected our peripheral areas as well. For too long, both our countries have been indifferent to rural people.
Instead, try to tie your experience to some universal, without explicitly linking the two countries. Here’s an example:
I was used to rural communities, like my father’s, being invisible in politics and in pop culture. What I was shocked to learn, when I shadowed a physician, was about their complete absence in healthcare education. The doctors who treated the rural patients who’d driven into the city weren’t aware of the water contamination in their communities, and were baffled by their complete lack of vaccine coverage. I wanted to become a doctor as a first step towards redressing that imbalance.
Step 5: Complete the AMCAS Work and Activities section (2-3 months before deadline)
Similarly to many Canadian universities, AMCAS lets you describe up to 15 extracurricular experiences at a maximum of 700 characters, and three at a maximum of 1,325 characters.
Our guide on the Work and Activities section will tell you which activities to select (don’t include all of them—choose your 15 best) and how you can effectively write about them. Just as the personal statement is your chance to explain the “big picture” qualities and experiences that would make you a great doctor, the activity descriptions aren’t just a space to describe exactly what you did during each activity, but what you learned and what it proves about the sort of doctor you would be.
Each activity description should, ideally, point to a different attribute of who you are. And as always, don’t assume American readers have context to understand, say, why it’s valuable that you worked at an indigenous healing center in Canada. Tie those more distinctively “Canadian” activities to broader, transnational issues—explaining, for example, that the healing center taught you about how mainstream medicine has ignored the needs of marginalized groups.
Step 6: Complete your secondary application (~2 weeks after deadline)
After reviewing the materials we’ve covered so far, most schools will ask you to complete a “secondary application.” This will consist of an application fee, a series of yes or no questions about your background, and often a few short essays. Like the personal statement and the AMCAS activities descriptions, these are an opportunity to highlight the characteristics that would make you a great doctor.
Our guide to medical school secondary essays will explain the sorts of questions you’re likely to be asked and how to answer them, including
The Diversity essay; (e.g., “Our university benefits from a variety of perspectives, as does the medical profession.What unique perspective do you bring?”)
The Challenge essay (e.g., "Describe a significant challenge you overcame and what you learned from it.”);
And the "Why us?" essay (e.g., "Why do you hope to attend [our school]?")
All are broad enough to allow you to expound on all those doctorly attributes.
If you choose to use your Canadian identity to answer the diversity question, try to use an experience which most American applicants are unlikely to have had. For instance, as a Canadian, you’ve grown up in a public healthcare system that, while universal, has to deny patients certain expensive but highly effective surgeries. How does your perspective on that add value to American hospitals and your future American peers?
But don’t assume that your diversity essay has to be about your non-Americanness. Your academic background (maybe your BA was in English), non-medical interests, or ethnic, racial or gender identity might, actually, give you a far more interesting perspective to offer. So don't limit yourself!
Also, pay particular attention to the question on why you’re interested in this specific school. Canadian students especially should not answer this question generically, regurgitating the school’s mission statement or talking about its incredible faculty and the clinical exposure that it provides.
Look in to the school’s curriculum, its faculty, its research, its relationship to its area, its community projects. Tie your narrative to your own story. If you do all that you’ll surpass the biggest obstacle for Canadians trying to get their MDs in the United States: the perception that they’re there for the degree and won’t remain and to fill the doctor shortage.
Step 7: Prepare for Interviews
If admissions committees have liked your primary and secondary applications, schools will invite you for an interview sometime between mid-October and February. Most American medical schools use the traditional panel format for their interviews, though some use the Multiple Mini Interview style common across Canada or some other strange concoction that they’ve brewed, in-house.
Our comprehensive guide to medical school interviews will help you prepare for these, so look through it. And be sure to check your schools’ websites for information on precisely what interview format they use.
Getting into medical school is tough. And as a Canadian, you might feel like the odds are even slimmer if you’re applying to schools in the US. But it’s possible if you’re able to achieve high stats and ensure that your background, experiences, and essays align with the type of students they’re looking for.