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Do you need to pay the entire tuition up front or annually?

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I am quite confused as to how a Canadian matriculant will have to pay for a medical education in an American medical school

Do you need to pay the entire sum up front, before the beginning of first year, or do you pay before the beginning of each year the tuition for just that year?

I've heard different things so I am confused as of now.

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Not that i am the best expert on this but usually I believe it is every year but some schools want you to demonstrate that you have the means to pay for the entire thing before you start (so they can be sure they are not wasting your or their time with things.) So that can lead to some confusion for sure as showing you have enough and actually paying it can sound kind of similar. 

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To get your I-20 (the document you show at the US border to legally enter as a student) you have to prove to your school's international office that you have the means to pay your cost of attendance for just your first year. This can be through a combination of financial aid offers, scholarships, bank statements, etc.

However, schools can require international students to put as much as the 4 year cost of attendance into an escrow account to matriculate. I've found this to be common for schools that accept internationals but don't give any financial aid. It's also up to the school whether you pay 4 years of tuition upfront or if you're billed every year/semester/quarter/etc. 

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