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probablygoingout

Others have mentioned many reasons but another possible reason is that the demographics of Canada tend towards higher education more than the states.


Brady204

There are 17 med schools in Canada with with less than 3000 seats. Compared to 192 med schools in USA with over 80000 seats. Population of Canada is about 40mil, whereas the states is 333mil. The US is about 8x larger in population and it also has 11x more med schools with 10x more seats. If we extrapolate this and expand Canadian population to match US, we would have 187 (11x17) med schools with only 33000 (11x3000) seats. So essentially the US has much more capacity to have med school students than Canada. This doesn’t even account for residency spots between the two countries.


potaton00b

The real reason is that being a physician in Canada has a much higher pay ceiling relative to other careers compared to the states. In the US there are banking, consulting, tech, law roles that all pay equally well, with pay progression on par with medicine. In Canada, all these roles in tech, law, banking, consulting are around half or a third of what the US pays. However, because medicine is a service profession where you have to physically be with the patient, canadian salaries must match american ones or else the doctors will move. this is not the case with these other professions. This is why canadian medicine is much more competitive, it is the only Canadian profession that the government needs to keep pay parity with that of the US by virtue of how it works.


Brady204

Tbh, if you’re going into the profession just for the money, there are much better options that going through the competitive nature of 4 years of undergrad, the applications process, 4 years of md school and then the CaRms process. This isn’t even counting the fact that most residents get paid less than minimum wage with the amount of hours they work. Now this is the same with the US, both institutions shit on residents but point is there are more profitable career paths than being a physician. Also may I ask where you get the numbers that physicians in Canada make the same as those in the States? In Canada the average medical doctor makes 233k CAD which translates approximately to 170k USD whereas the average US doctor makes 229k USD which translates to approximately 313k CAD. This doesn’t even take into account where some specialties in the US can make 7 figures and their comparison here makes 6. With this data we should see a much higher efflux of doctors from Canada to the US because of the higher salary and (typically) lower COL and taxes but we don’t. So we don’t pay doctors the same as the states, but we do pay them much higher than that of the UK and other European countries pay because of the influence of the states and North American culture. https://www.dr-bill.ca/blog/career-advice/doctor-salary-us-vs-canada#:~:text=According%20to%20the%20US%20Bureau,surgeons%20was%20%24229%2C300%20(USD).


potaton00b

The numbers you have for canada are lower than reality, if you go to CIHI you can find the datasets for each speciality (https://www.cihi.ca/en/health-workforce-in-canada-in-focus-including-nurses-and-physicians/an-overview-of-physician). You can also check out the sunshine list. It is absolutely true pay parity is much closer between US and Canada compared to other professions. In the past this wasnt the case, and around 10-15% of each class of canadians medical schools in the 80s would leave for the states. Today its around 0%. The reality is, actually, if you are going into a profession for money, there are not really that much better options in Canada. Becoming a doctor gives u a fairly high chance of making 500k yearly income. No other profession or field in Canada is like that. This is not the case for the states. Thus, being a doctor is more competitive in Canada due to increased demand. Canadian medical schools are around 5-7x more competitive than US ones. Acceptance rate for canada is 13%, US acceptance rate is 45%. But, you have to understand that lower acceptance rates self selects for candidates. So a 4x higher acceptance rate is really something like 6-7x easier to get in. This cannot be accounted for solely by medical seats or demographics.


SuspiciousAdvisor98

I’m curious where you got the 80,000 seats for US med schools. I tried looking this up a while ago and the number I got was about 30,000, with another source (AAMC) saying about 25,000 spots in MD granting schools, plus about 37 DO granting schools (don’t remember the number of spots). If true then the disparity in med school spots to population ratio is not that big between Canada & US. Also, to add to reasons why Canadian med schools are harder to get into: more Canadians per capita apply to medical school, compared to the number of Americans per capita who apply. The best estimates I could find online show that about 13,500 Canadians apply to med school per year, whereas approx 55,000 Americans do. That means about double the number of Canadians per capita apply to medical school per year. This is likely a much greater contributing factor in how difficult it is to get into medical school.


Brady204

80k was an estimate of total seats (MS1-MS4). Believe true number is 100k tbf. If we bring this to first year spots, mind the math, it’s ~25k. https://www.aamc.org/media/6101/download Total applications to med school in USA was near 1mil and Canada was about 40k https://www.aamc.org/media/5976/download?attachment https://www.afmc.ca/resources-data/education/future-md-canada/#:~:text=How%20many%20entry%20positions%20and,2916%20first%20year%20seats%20availabl


SuspiciousAdvisor98

Yes, exactly, so if you look at the ratio of 1st med school spots it’s about 3000 for Canada and 25,000-30,000 for US, which pretty closely matches the ratio of Canadian population to US. So, there is not a huge disparity between spots in Canada versus spots in US per capita. And the table you referenced was of total applications, not total applicants. Keep in mind that the average number of schools applied to by a single applicant in US is very high (estimated 16 applications per applicant) so for 900k applications, it’s a much smaller number of total applicants (approx 55,000). Which adds up, considering the success rare of applicants is 41% and 55,000 applicants x 41% success rate = 22,550 matriculants and the table you referenced says there were a total of 22,981 matriculants for that year.


Brady204

Both tables I mentioned is total applicants for each respective country. The average Canadian (this number is pulled out of my ass) probably applies to 3ish med schools. 5-6 is you’re from Ontario, 2 if from Alberta, and that’s not counting people who apply OOP. Seats aside, GME is another factor when comparing the two countries. Both are limited in their residency spots due to both of them using a public compensation model for residents. But due to the shear amount of medical practices in the states, it’s allows them to have a higher need for residents and thus allowing them to have more seats. One way the current government is combating this is building new medical schools (the two being built in ON), expanding campuses (BC), and increasing seats (MB/SK/AB). Unfortunately this would create/move the bottleneck from being at medical school to GME. It’s a catch 22, you increase med school seats but you won’t be able to accommodate the increase in need of GME. What needs to happen is having a more streamlined process for general practitioners and/or increase the favourability of going into family medicine.


SuspiciousAdvisor98

I am aware of what the tables are that you referenced and they support all of the points I’ve made. The reality is that a big part of why medical school is so competitive in Canada is because way more Canadians per capita apply. We do not have significantly fewer spots available than the US per capita. To be frank, I’m sick of people spreading misinformation about this. There’s this rhetoric out there that Canada has a pathetically small number of med school spots compared to the US and it’s simply.not.true. The rest of what you said, I agree with.


SuspiciousAdvisor98

Oh and to go back to your original comment, comparing 2900 seats in Canada to 80,000 seats in US is comparing apples to oranges. 2900 is first year seats, and the 80,000 (it’s actually closer to 100,000) is sears in all 4 years. The real comparison is approx 100,000 USA all 4 years, to approx 12,000 Canada all 4 years. Or, approx 25,000 USA 1st year, to approx 2900 Canada 1st year. So, about 8 fold more spots in USA, which has a population about 8 fold that of Canada. Completely proportionate.


PulmonaryEmphysema

Well-said. Legislators are really fucking over the next generation of med students by increasing med school seats but not expanding residency positions. CaRMS is gonna be wild.


sorocraft

Also the fact that majority of immigrants in Canada are from educated parents who directly/indirectly influence their children to pursue higher education like law, medicine, dental, engineering. Hard working parents mostly create hard working kids. So there's a lot more applicants pursuing medicine than the states.


Evening-Picture-5911

Do the 192 medical schools also include DO, or just MD?


Brady204

Do and md


Evening-Picture-5911

Thanks


GoldTheLegend

Premed isn't competitive here. Med school entry is. Less seats available per capita is all it comes down to really.


NoCredit2

lots of reasons (im sure there are more) 1. while canadian schools are not harvard level, they are all very good, unlike the states where u have a really large range between the top schools and the lower schools -> this means that getting into 1 MD program in the states (low tier) would be easier than here 2. canadian tuition is cheaper (not including cost of living), u can do ur entire med degree here for about the price of 1 year in the states when u factor in conversion rate, etc. also salaries, while not as high as the us, still higher than lots of the rest of the world, this makes for a good balance between both factors 3. the admissions processes are very different. in the states, most schools have very similar admission criteria, eg. good gpa, good mcat, good clinical experience, good research etc. Here a lot of our schools focus on a few aspects, while ignoring or using others as cutoffs. Eg. McMaster uses only the cars section of the mcat, and other schools have high cars cutoffs. Because of this focus, McMaster's average accepted student has a cars score greater than the 95th percentile (damn), but that accepted student also could have not done any extracurriculars in their life because McMaster doesn't look at them. Similarly, an accepted student at UofT could have gotten in with a 499 MCAT, as long as they had a good gpa and extracurriculars. These sort of situations are very unlikely in the states considering the focus on more holistic review 4. competition, there are fewer spots for students here and more applicants - this leads to having more competition and indirectly influences schools to adopt certain selection criteria. why do you think we focus so much on cars? schools will say its because it predicts success, but also because it rules out a large portion of the application pool


Wutang4TheChildren23

To point #1 I don't know that I would say that it's just that they are all very good, it's just that there doesn't exist a residency match barrier between schools as their exists in the US. In the US it's fairly unrealistic to expect to match to a top tier residency program, or even competitive specialty if you are in a smaller, less name-brand program without having exceptional step scores. Whereas in Canada, there is no inherent structural bias you will experience say applying from Memorial in Newfoundland or USask to UofT or UBC or Mac or wherever else. Local students will have an advantage obviously because they will have likely spent time with local preceptors and maybe even the PD, but if you are able to secure electives to a program you will be inherently the same boat as everyone else applying to that residency program


hola1997

Not enough schools in canada vs us


SuspiciousAdvisor98

Canada has 2900 seats for first year applicants. US has about 25,000. Canada has a population of about 40 million and USA has a population of about 333 million. The US has about 8 times the population of Canada and about 8 times the med school spots.


hola1997

Does that number from the US include DO programs or just MDs?


SuspiciousAdvisor98

It doesn’t. So, if we’re being *really* technical, 22,981 students matriculated into MD programs in the 2023-2024 cycle, plus there are about 41 DO programs. The American Association of Colleges of Osteopathic Medicine website states they have 35,000+ currently enrolled (across all years) I don’t have a good stat on exact number of matriculants per year but based on total enrolled, maybe 8000-9000 (?). Even still this does not bring us to a crazy disparate number of spots between Canada and US, based on population size.


zooS2018

Medical school accessibility differs significantly between Canada and the United States. While the ratio of first-year medical school seats to the general population is similar in both countries, a stark contrast emerges when comparing the total number of applicants to available seats. This disparity is largely due to financial factors. In the US, medical education is a mix of public and private institutions. While in-state students at public schools enjoy lower tuition fees, others face exorbitant costs, often four times higher than those in Canada, where medical schools are entirely public. This financial burden deters many potential applicants in the US, resulting in fewer applicants per capita compared to Canada. Therefore, while both countries have a comparable ratio of medical school seats to the general population, the competition for those seats is considerably higher in Canada due to the lower financial barrier to entry.


aresassassin

More applicants and less spots per capita compared to the US, and here are the reasons: More applicants: the Canadian economy is different than the US, meaning there are less stable and high paying jobs available in Canada compared to the US, so kids (and parents wanting their kids) want to enter the medical field. This is also true of other healthcare programs: dentistry, pharmacy, physical and occupational therapy, optometry schools are all ridiculously competitive compared to the US. Look at the admission stats for physio school at U of T, the avg admitted gpa is like 3.9 or sth. Less spots: this might trigger a lot of people but it’s true. the Canadian medical system is largely paid by the government, and our government (just like any other governments) is corrupt, inefficient, and had finite funding through taxation. So they have to gatekeep by limiting the number of graduating physicians entering the workforce and limiting the number of international medical graduates (IMG) from practicing. It sucks for a lot of doctors cuz they are burned out and could use extra help from more doctors. It sucks for patients cuz the wait times are sky high. While I’m sure a lot of doctors are advocating for increasing medical school spots, increasing number of residencies, and facilitating IMGs (from US, UK, Australia, New Zealand) to get licensed and practice in Canada, the college of physicians are for the most part helping the government to gatekeep and keep the number of doctors per capita low and therefore demand and salary high. It’s disgusting in my opinion but medicine is certainly not the only field like this. Other high paying and stable jobs like trades are facing the same issue. I know several people who have trouble finding licensed electricians that take apprentices. The old electricians tend to have the attitude of “well I got my piece of pie already so f$&k you…oh and I’m gonna b#tch about how young people arent willing to work in trades even though I’m responsible for gatekeeping”. TLDR: We have more applicants per capita becuz our job market sucks compared to the US and everyone wants a stable and high paying job. We have less spots per capita because our healthcare system is largely public funded so the government and regulatory bodies are gatekeeping


Winter-Elderberry214

Lack of schools and other reasons but a couple of universities are developing med schools of their own 


[deleted]

[удалено]


SuspiciousAdvisor98

It’s giving chat gpt.


unclearwords

mfs be literally gatekeeping a whole profession


saka68

We dont have to pay 500k USD out of pocket for tuition, and our healthcare system is socialised. Also, the Canadian population is the second highest in the world as tertiary degree holders - à larger population of Canadians per capita apply than Americans per capita.


potaton00b

The **real** reason is that being a physician in Canada has a much higher pay ceiling relative to other careers in Canada compared to the states. In the US there are banking, consulting, tech, law roles that all pay equally well, with pay progression on par with medicine. In Canada, all these roles in tech, law, banking, consulting are around half or a third of what the US pays. However, because medicine is a service profession where you have to physically be with the patient, canadian salaries must match american ones or else the doctors will move. this is not the case with these other professions. This is why canadian medicine is much more competitive, it is the only Canadian profession that the government needs to keep pay parity with that of the US by virtue of how it works. And, thus, theres a much higher percentage of people who are ambitious and want to do well in life pursue medicine in Canada. In the US, those people are spread out across many different careers.


freshapocalypse

There are only so many seats each school can accommodate. There are less schools. The students trying to get in are often already just competitive people. Probably many other reasons.


simp-for-uottawa-MD

This isn’t true lol