We all know that getting into medical school in the United States is tough, but how does it compare to other countries?
Determining how difficult it is to get into medical school in a particular country is not as simple as looking at acceptance rates. There are many other aspects of medical school admissions like GPA, test scores, prerequisites, and even the steps leading up to the medical school application that needs to be considered.
Here’s how the U.S. compares to Canada and the United Kingdom.
The United States
Let’s set our baseline and discuss how difficult it is to get into medical school in the United States. According to data from the AAMC, AACOM, and TMDSAS, only 36% of students that apply to U.S. MD and DO schools matriculate, and only 25% of students that apply to Texas schools matriculate. With these statistics, it is not uncommon to hear of premeds applying multiple times, only to be met with rejection. So, what makes getting into medical school in the U.S. so difficult?
It starts with the structure of medical education. Unlike many other countries where you begin your medical training after high school, getting into medical school in the U.S. requires you to complete a four-year bachelor’s degree first. This adds to the difficulty as there are now two points in the process where aspiring physicians are screened – once during the transition from high school to college and again during the transition from college to medical school.
Let’s say you have 100 high school students interested in going into medicine. Out of those 100 students, maybe only 75 of them will get into college and become premeds. Now, out of those 75 students, maybe only 20 of them will complete all of their prerequisites, take their MCAT, and apply to medical school. And, out of those 20 students, maybe only 8 will get in.
If you only look at the last part of this example, you might see a matriculation rate of 40%. After all, 20 students applied and 8 got in; however, this doesn’t tell the full story. It doesn’t account for all the students that were “weeded out” along the way.
So, when you look at the figure that only about 35-40% of premeds in the United States matriculate into MD schools, you also need to consider that there are many more premeds that dropped it altogether and never made it to the stage of applying to medical school.
It should be noted that there are also combined seven- to eight-year BS/MD programs in the U.S. that grant both a bachelor’s and an MD; however, they are often considered even more competitive than the traditional 4+4 model.
Another factor to consider is that applicants are self-selecting. Medicine is known for being a long and intellectually demanding career path. As such, the students that tend to pursue careers in medicine tend to be those at the top of their class already. So, if you are one of 50 students fighting for a spot in a particular medical school, you’re not just competing against 49 other average students – you’re often competing against 49 other high-achieving students.
Don’t forget the classes that premeds take either. U.S. medical schools generally require 1 year of biology with lab, 1 year of general chemistry with lab, 1 year of organic chemistry with lab, 1 year of physics with lab, and some math, generally some level of calculus and/or statistics. Although there are subjects such as rocket surgery that are much more intellectually challenging, the amount of time and effort needed to get an “A” in these classes is often higher than in most other subjects.
It’s not enough to just make it through these classes either, you also have to excel in them. The average GPA for matriculants into allopathic MD programs is 3.74, osteopathic DO programs is 3.64, and Texas medical programs is 3.81.
In addition, the average MCAT scores for matriculants are 512, 504, and 511 respectively. This means that to be reasonably competitive for U.S. medical schools, you should aim for at least the 58th percentile for DO schools and between 80 to 84th percentile for US MD and Texas schools.
Hard metrics aren’t the only thing considered in medical school applications either. There are also various extracurriculars needed to make one a competitive applicant. More specifically, it’s recommended to accrue around 150-200 hours of volunteer work, 50-75 hours of physician shadowing, 30-40 hours of patient exposure, around 200 hours of research experience, and multiple examples of leadership experience on top of attaining a high GPA and MCAT score.
As such, finding the balance between extracurriculars and academics can be incredibly difficult for many premeds.
With that as our baseline, let’s see how difficult it is to get into medical school in other countries.
2 | Canada
The process of getting into medical school in Canada is very similar to the U.S. Although some programs do not require the completion of a 4-year degree, most premeds in Canada will complete their bachelor’s degree before applying to medical school.
The difference, however, is that medical school matriculation rates are even lower than in the U.S. at around 20% nationally. The average GPA and MCAT score for Canadian medical school matriculants also tend to be higher on average than in the U.S. The average GPA for matriculants is between 3.7 and 3.95 depending on the school and the average MCAT for students with at least one offer is 512.5 which is around the 85th percentile.
One reason that medical school is so competitive in Canada comes down to the number of applicants per first-year medical school spot. In Canada, there are approximately 15,000 applicants competing for 3,000 medical school spots in any given year compared to the U.S. which has 62,000 applicants competing for 23,000 spots. That comes out to approximately 5 applicants for each spot in Canada versus 2.7 applicants per spot in the U.S.
Additionally, prerequisite coursework in Canada can vary widely between schools, so premeds need to pay more attention to the requirements for each program. The most common requirements are 2 semesters of biology, 2 semesters of chemistry, 2 semesters of physics, 1 semester of math, and 2 semesters of English; however, some schools require coursework in biochemistry, anatomy and physiology, psychology, and/or social sciences as well.
Around 70% of medical schools in Canada also require applicants to take the Casper test as a part of the admissions process. In comparison, only about 30% of medical schools in the U.S. require Casper. While this doesn’t necessarily influence competitiveness, it is another hurdle to jump through.
Extracurriculars for Canadian medical schools are also similar to U.S. medical schools with research, volunteer work, leadership, and clinical experience being an important part of one’s application.
3 | The United Kingdom
In the United Kingdom, getting to medical school is quite different from the United States and Canada. Although you can complete a 4-year bachelor’s degree and then apply for a 4-year medical school program through the graduate pathway, this is not the norm.
The standard pathway to becoming a doctor in the UK is to apply for a 5-year medical school program right after secondary school, the equivalent of high school. After that, you’ll complete a two-year foundation program with the National Health System followed by either 3 years of general practitioner training or 5-8 years of more specialized training. So, despite UK medical students starting their medical training earlier, the total amount of time from high school to practicing physician is similar to that of the U.S. or Canada.
Now let’s talk about admissions data. In 2021, there were around 29,000 applicants competing for around 9,500 medical school spots. This gives us a matriculation rate of around 33% – which is less than that of the U.S. but greater than that of Canada. That being said, acceptance rates can vary widely between schools with some schools reporting rates below 9% and others exceeding as high as 30%.
One important caveat to note, however, is that UK students are limited to 4 medical schools on their application, so they are often much more particular with which schools they apply to. This is very different from the U.S. where it is generally recommended that premeds apply to as many schools as possible – often 20 or more – to maximize their chances of a medical school acceptance.
In terms of the average GPA for matriculants, the UK follows a different grading scale than the U.S. and Canada which makes comparison difficult. In secondary school when students are around age 16, they will take their General Certificate of Secondary Education courses. These are the basic qualifications in the UK and cover a broad range of topics like Math, English, and Science. Towards the end of secondary school, around ages 16-18, students choose their “A-level” courses which are more focused.
Students generally take at least three A-level courses; however, some will take an extra A-level to try to make themselves more competitive. Most medical schools have specific requirements for what A-levels a student must take – generally biology, chemistry, and one other science-related subject – as well as the grades that students must achieve. Most programs require at least three A’s, or 70% or above, in your A-levels to be considered for their medical school with some requiring A-star grades, 80% or above, in one or more of your A-level classes. According to Statista, approximately 19% of students achieved A* grades on their A-levels in 2021 and over a quarter received A grades.
In terms of test scores, most medical schools in the UK require students to take the University Clinical Aptitude Test or UCAT. The average UCAT score for low-tier schools is generally between 2400-2500 which is a 50th percentile score and the average UCAT for higher-tier schools is generally above 2700 which is an 80th percentile score.
Which Country’s Medical School is Most Competitive?
Now that we’ve gone through each country in detail, which one is the most competitive?
Based on the data, Canada is the most competitive. The process and requirements of getting into medical school are very similar to the U.S.; however, more students are competing for each medical school spot. This means that medical schools can be more selective with whom they choose to accept, which is evident in the slightly higher average GPA and MCAT score.
Between the U.S. and the UK, the U.S. is substantially more competitive. Not only because the average matriculants’ MCAT percentile is substantially higher than the average matriculants’ UCAT, but also the fact you first go to college and then apply to medical school in the U.S. The premed years are cutthroat and highly competitive, and the overwhelming majority of premeds on the first day of college are no longer premed by the time they graduate. Whether it’s organic chemistry, physics, or the MCAT, there are many tough hurdles to overcome during college that stop premeds from applying to medical school.
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If you enjoyed this article, be sure to check out 5 Reasons Premeds Fail to Get Into Medical School or United States vs Canada | Medical School and Becoming a Doctor.
