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What makes med school admissions so much more competitive in Canada compared to the US?


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Really just wondering out of my own curiosity here.

For the 2020-21 cycle, the AFMC reported that there are ~3023 seats for first-year matriculants among Canadian medical schools. Comparatively, there were 21869 first-year matriculants to US med programs in 2020, as reported by the AAMC. This translates to ~80seats/million population in Canada and ~67seats/million population in the US. I would probably guess too that there are more applicants per seat in the US because their schools are in general way more liberal to accepting international applicants compared to Canadian schools. Canada also has less practicing physicians/million people than the US, which should also mean that (maybe?) there's a greater need for training more doctors here especially given our aging population (although I guess the US has much higher rates of obesity and such, so maybe this is a bad argument). 

One thing I did consider are differences in barriers to entry. Tuition also costs a fraction here compared to what it costs in the US, our attendings make around the same money, and student loan repayment plans are much more generous here (e.g., my alberta student loans remains interest-free until I finish fellowship and I don't have to pay anything back before then). So I guess, this might mean that there are less barriers to apply here, especially for people from lower SES backgrounds (unsure if this is supported by the data though).

Still, there's a >40% acceptance rate in the US and it's closer to ~10% here. That's not exactly a small differences which can be easily explained by something like a higher post-secondary enrolment per capita or a lower barrier to entry...

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I don't think AAMC regulates seats for DO schools. if you add those seats that will change your number to 90 seats/million people in the US, so more than Canada.

Also, you're right. Undergrad is cheaper here, and more equality overall means more students are in a position to apply in canada than they are in america. this is a good thing, as frustrating as it might be for premeds. 

Seats are also very tightly regulated based on the provinces' budgets for healthcare, not based on how many we 'need', so that has also prevented schools from increasing their class sizes. Trust me, if they could double the seats and get twice as much tuition paid to them, they would.

 

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The average US applicant is way way less competitive than the average Canadian applicant. Furthermore, you have a not in-significant number of American applicants who send in apps with literal <3.0, <500 stats which almost never happens here for obvious reasons so looking at admission rates per capita is meaningless without also considering important variables like the applicant pool. 

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You're looking at seats and population, but you're not looking at applicants, which is where the difference lies. The latest data I could find for the US is 2020 and Canada is 2019.

Canada had 14664 applicants for 2640 positions (including negligible deferrals) meaning that 18.0% of applicants matriculated. US had 53030 for 22239 positions demonstrating at 41.9% applicants matriculated. So right there we can see that the acceptance rate in Canada is less than half the US. When talking about population, that year 0.039% of Canada's population applied, and 0.015% of the US's population applied, meaning Canada has twice as many applicants per capita than the US. And Canada and the US basically have the same number of spots per capita (0.0070% and 0.0068% respectively). Note that this does not account for population distribution, there are not too many 3 year olds or 80 year olds applying to medical school so a more realistic stat would be like population from 20-40 but that would take a bit of digging to find...

Anyway I think you're on the right track in terms of the reasons for the application numbers disparity, it could be due to SES differences or rates of post-secondary education which may be higher in Canada as you say.

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1 hour ago, bearded frog said:

You're looking at seats and population, but you're not looking at applicants, which is where the difference lies. The latest data I could find for the US is 2020 and Canada is 2019.

Canada had 14664 applicants for 2640 positions (including negligible deferrals) meaning that 18.0% of applicants matriculated. US had 53030 for 22239 positions demonstrating at 41.9% applicants matriculated. So right there we can see that the acceptance rate in Canada is less than half the US. When talking about population, that year 0.039% of Canada's population applied, and 0.015% of the US's population applied, meaning Canada has twice as many applicants per capita than the US. And Canada and the US basically have the same number of spots per capita (0.0070% and 0.0068% respectively). Note that this does not account for population distribution, there are not too many 3 year olds or 80 year olds applying to medical school so a more realistic stat would be like population from 20-40 but that would take a bit of digging to find...

Anyway I think you're on the right track in terms of the reasons for the application numbers disparity, it could be due to SES differences or rates of post-secondary education which may be higher in Canada as you say.

Thanks for that info! I used population/seats as a surrogate because using the sum of the no. of applicants to each school wouldn't make sense since most people apply to multiple schools and would be counted repeatadly, and I couldn't find data on the total number of unique applicants when I looked initially.

18% acceptance is definitely a lot higher than I thought it would be though, since every individual schools in Canada seems to have at least a sub-15% rate even when considering total acceptances/total applicants. But the AFMC report you linked does say UofT and western did not contribute data, so it's likely that there are more applicants than 14664. 

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1 hour ago, offmychestplease said:

The average US applicant is way way less competitive than the average Canadian applicant. Furthermore, you have a not in-significant number of American applicants who send in apps with literal <3.0, <500 stats which almost never happens here for obvious reasons so looking at admission rates per capita is meaningless without also considering important variables like the applicant pool. 

I agree that looking at the admissions rates per capita is a pretty crude measure. Also definitely valid that there is a lot of selection bias going on due to most Canadian schools having hard cutoffs on GPA/MCAT scores, while this is not common in the US.

But your other point doesn't make sense. If the average applicant in Canada is a lot more competitive and many sub-par candidates are applying in the US as you say, then the US should have a lower acceptance rate, because their no. of applicants is being inflated as compared to Canada (which is arguably also the case when you look at schools like Queen's who don't release any information and get rich on application fees from thousands of candidiates who will simply get their application thrown out without file review). If only "competitive" applicants even bother applying here, then there should be a much smaller pool of applicants here relative to available seats, not the other way around as is observed.

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It makes sense because the 40% US acceptance rate already includes the applicants with <3.0, <500 so the actual acceptance rate for someone with even half-decent stats is significantly higher. In Canada the acceptance rate is actually worse than it looks since the applicant pool is much stronger and already less people get in...so the acceptance rate is harder since you have better applicants and less people getting in overall as well.

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1 hour ago, offmychestplease said:

Canada the acceptance rate is actually worse than it looks since the applicant pool is much stronger and already less people get in...so the acceptance rate is harder since you have better applicants and less people getting in overall as well.

I think you're confounding "acceptance rate" with "required qualifications".

2 hours ago, zxcccxz said:

 But the AFMC report you linked does say UofT and western did not contribute data, so it's likely that there are more applicants than 14664. 

Good catch, I didn't see that! I used table F10 which is only missing U of T's data. Unfortunately while we can see from their own site that they got 3553 applications in 2019 for 259 seats we have no way of knowing how many just applied to U of T. The average applicant applies to more than two schools, yet based on the Canadian stats more than a 3rd of all applicants only applied to one school (5636 of 14664, or 38.4%). I have no way of knowing if U of T gets more or less single application applicants than other schools, I would guess less as it has no Ontario preference, but I'm not going to try and extrapolate that and will instead just add 38.4% of U of T's 3553 applicants to the total giving 16028 for 2899 spots including Toronto's, resulting in a national matriculation rate of... 18.1%. So U of T overall did bring up the rate by 0.1%! It also means that the application per capita rate gets bumped up to 0.043%, or almost triple the US rate.

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12 hours ago, zxcccxz said:

18% acceptance is definitely a lot higher than I thought it would be though, since every individual schools in Canada seems to have at least a sub-15% rate even when considering total acceptances/total applicants. But the AFMC report you linked does say UofT and western did not contribute data, so it's likely that there are more applicants than 14664. 

The 18% is heavily skewed by Quebec med schools imo, where getting into med school is much less competitive than the rest of Canada.

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5 hours ago, keipop said:

The 18% is heavily skewed by Quebec med schools imo, where getting into med school is much less competitive than the rest of Canada.

Table F-15 gives us exactly this information. If it's easier to get in Quebec, where the stats do seem to be lower, its probably not because of McGill. So we can narrow to french schools. Again they done have U of T data, but they get a total matriculation rate of 17.7% (2592/14664). According to this data, 17% (1745/10260) of English only applicants matriculated and 14% (457/3267) of French only applicants matriculated, but a full 34.3% (390/1137) of applicants to both English and french schools were accepted. There are 732 french seats in Quebec (lets ignore Ottawa's french stream) so if we consider all who applied to french schools, 16.6% (732/4404) matriculated.

So in summary in terms of raw numbers, there isn't an advantage in Quebec if everyone had the same stats and acceptance was random. However, this does not say what the average stats the accepted applicants have relative to other provinces. I don't know if that data is available. The document I've been citing has MCAT averages but I think its optional in Quebec so there isn't enough data there.

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If you consider the DO statistics from 2018, out of 20,981 applicants approximately 7,575 applicants matriculated (36.1%). A lot of these individuals may have also applied to the USMD route or were not competitive enough. With both the USMD and DO data considered, the admission rate to medical school might be closer to 50% than 40%.

50%/18.1% = 2.75; almost 3x harder to get into a medical school in Canada than in the US. I think this makes sense because on average a Canadian applies 2.5-3x before getting admission to a Canadian school. 

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You can’t really compare the acceptance rates in Canada vs the US. Applicants in the us apply to many more schools often at the touch of the button (same thing with undergrad in the us). You can’t really do this in Canada with the exception of Ontario schools. This skews the numbers in the us to show many more applicants per spot than would be otherwise. This is the same reason why you have alarmingly high acceptance rates for top Canadian undergraduate schools compared to the us because applicants don’t typically apply to many schools due to the amount of labour that would be required to do so.

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1 hour ago, dentistrydmd said:

You can’t really compare the acceptance rates in Canada vs the US. Applicants in the us apply to many more schools often at the touch of the button (same thing with undergrad in the us). You can’t really do this in Canada with the exception of Ontario schools. This skews the numbers in the us to show many more applicants per spot than would be otherwise. This is the same reason why you have alarmingly high acceptance rates for top Canadian undergraduate schools compared to the us because applicants don’t typically apply to many schools due to the amount of labour that would be required to do so.

Nobody is using applicants per seats as a metric though... if you just compare the total number of applicants to the total number of seats, it makes no difference if the average applicant applies to 20 schools of 1 school, there X% number of applicants will get a seat, and if the number of applicants who ultimately get admitted is lower (as it is in Canada vs. US), then it's more difficult to gain admission.

And acceptance rates for top Canadian schools are so high because we have a public education system that aims first and foremost to educate as many individuals that want post-secondary education... this is in contrast to the US where all the top schools are private, and purposefully aim to maintain a level of "exclusivity" among its matriculating cohorts.

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Where are the numbers of applicants data coming from? In Canada there is no unified system for applications as in the US so there is no way to determine how many applicants there are (ie. There is no way to determine if an applicant to UBC has also applied to UOttawa or not. Likely the numbers being shown are applications rather which would make sense since most students apply to their in province schools...

 

No that is not the reason there are high acceptance rates. Again there is no unified system for applications and people in the US have many more schools to chose from thereby increasing the number of applicants to each program. It’s the same reason why UK schools also have higher acceptance rates. Typically a student in Canada will apply to a few schools while in the Us the typical applicant will apply to ~15-20 schools. 

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The AFMC tracks everyone, it's the only way to release the CMES report (which includes stats like "Average # applications per applicant" that can't be collected otherwise. Not a perfect system as far as data collection and the descriptive survey go (I received the applicant survey twice...) but they can easily track the basics using data schools provide. There are many ways to easily match large datasets quickly and with all the info people input into the same portals over and over again it's quite easy to match people. People usually only have one main mailing address, one name, will use the same email, etc... 

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Out of curiosity I looked at OMSAS data (which is only up to 2018), almost had a dissection, the number of applicants has skyrocketed while # of seats is stagnant. 

# of applicants will increase just with population increase, but seriously no increase in seats for all those years?

Can't fathom what it's like to be a premed these days. Older timers who got in with 3.8 GPA probably look dumb as doorknobs compared to people these days with 3.99 and not getting interviews lol.

I guess our system is "supply managed" well by the government eh.

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