US Medical Schools: Are They Worth It For Canadians?

Getting accepted to medical school is difficult.  You’ll be shocked by our analysis at how long it takes a Canadian going to medical school in the US to pay back tuition debt.

Surely we’ve all heard this axiom, but how difficult is it really to get into medical school in Canada? Every year in Canada, thousands of students apply to receive admission at one of the country’s 17 medical schools. Ontario’s McMaster University received 4,973 applicants in 2014 to fill only 204 available spots. For the province at large, Ontario had 6,593 applicants apply for 954 medical school spots, good for an overall acceptance rate of about 14%. Although Ontario is the most competitive province for medical school, the other provinces aren’t much easier.

Figure 1: Acceptance rates at all 17 Canadian Medical Schools.

The data in Figure 1 shows that the odds of getting into any of Canada’s medical schools are slim. Many of the provinces do give preferential treatment to in-province applicants, giving those students slightly better odds. The Canadian Medical School system rejects thousands of prospective doctors yearly, many of them qualified applicants. Dr. Evelyn Sutton aptly summed up the issue by saying “We have excellent candidates every year that have to be turned down… we need more seats”. Unfortunately, this means many qualified applicants won’t get the opportunity to get an education from a Canadian medical school.

These students will either attend graduate school with the hope to of gain admission in a later year, or they can look to attend medical school internationally. If students chose to study abroad, they have the option to take up permanent residency in their country of study or attempt to come back to practice in Canada. Ontario funds about 200 residency slots for international medical students, with about two thirds of those going to Canadians studying medicine abroad. Considering over 800 students have gone to study medicine abroad and are looking to repatriate, the odds are about in line with getting into Canadian medical school.

Diagnosing U.S. Medical Schools

If you had your heart set on attending Canadian medical school and didn’t get the opportunity to do so, you have options. Despite the dispiriting result, one option to consider is attending medical school in the United States, provided you are accepted. Although it might be more difficult to practice in Canada afterwards, there are many opportunities to practice in the United States. A list of U.S. medical schools that admit international students can be found here.

Attending medical school in the United States is extremely expensive. Out-of-state tuition fees are very high. In many cases you will be required to prove your ability to pay four years’ worth of tuition, which means you will have to hold a large sum of money representing the entirety of your tuition in escrow at the onset of your medical school career.

Access to financing also becomes more difficult for Canadians looking to attend medical school in the United States, as financial aid programs such as the Ontario Student Assistance Program (OSAP), won’t be available to you. If you require financial aid, the funds will need to be sourced through a line of credit or similar arrangement, which is less forgiving than financial aid programs would otherwise be.

Given this information, it’s evident that the prodigious financial commitment of attending medical school in the United States can be onerous. Also, studying in a different place can be a challenge. You’ll be surrounded by new people and there’s always a possibility of miscommunication as slang words might be different. Let’s quantify just how onerous it really is.

Dollars and Sense – It’s more expensive than you think!

The financial implications of attending medical school in the United States as a Canadian can involve many variables. As champions of science have decreed for centuries, as much data as possible should be collected before arriving at conclusions. To determine the true cost of medical school to a Canadian prospective student, let’s consider a typical payment schedule for a Canadian attending medical school in the U.S., deriving most inputs using national averages, which are sourced in the spreadsheet. The key underlying assumptions made include assuming the medical school required the student to hold four years’ tuition in escrow, and that the student did not receive any financial assistance from family, friends, or past savings.

Figure 2: Select statistics pertinent to attending medical school in the United States as a Canadian

Repaying medical school debt is no simple task, as interest on your line of credit will begin to accrue immediately. Factor in four years of school (and thus lost income), and somewhere between 3-5 years of residency where you will only earn $55,300 in annual remuneration, your debt repayment schedule can become longer than anticipated. A debt repayment amount totalling 30% of your after tax income was assumed, but if you plan to pay debt off at a pace that differs significantly from this pace, you can edit the attached model to better suit your medical school payment schedule.  This model also does not take into account possible exchange rates, so all figures are listed in $USD. If you happen to go to med school at a time where the U.S. dollar is very high, these costs could be inflated even more so in nominal terms.

Essentially, the years you are in school will see your debt swell, and your income from residency will be insufficient to make a material dent in your debt repayments. Once you’ve completed your residency, you will begin to make loan payments back quickly, as your earning potential increases significantly.

Figure 3: Typical debt repayment schedule, beginning in the first year of medical school

Final Prognosis
It will take you a total of 13 years following the completion of medical school to become fully debt free, but from that moment onwards you will be making a salary well into the six-figures carrying into retirement.

Overall, attending medical school in the United States presents an interesting predicament for young Canadians. While being very expensive, the career opportunities available to those who graduate are very attractive. If you are willing to live austerely for a few years after graduation, the debt will be very manageable, with an even shorter payback period.

Consider this analysis in tandem with the option of pursuing additional schooling and reapplying to Canadian medical schools the next year. For some individuals, one year of graduate school with strong marks could be enough for them to have a good chance at attending medical school in Canada. For others, attending medical school in the United States could even be preferable, regardless of the cost.

Additionally, remember that Canadian medical school can be expensive as well. Depending on the province, tuition can still be very expensive. The payback period for attending U.S. medical school should always be considered against the Canadian equivalent to make comparisons ceteris paribus.

Attending medical school in the United States has shown to be an option that is more than financially viable, so long as you are willing to live within your means after you have graduated. There is also the opportunity to practice medicine in Canada after you complete medical school in the United States. The process is not straight-forward, but it is still an option that is available to you.

Getting into medical school is difficult. Take the time to thoroughly research your options to determine the best one for you.

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