Get Started: Part 1 – Premed Basics

Becoming a doctor

For many of us thinking about becoming a doctor, we focus all of our current energy on getting into medical school. This is because right now, this seems like the hardest and most important part. While that may be true, you need to make an informed decision.

Life isn’t a piece of cake once you are accepted into medical school. You will continue to train for many years before becoming a fully licensed, independently practicing physician. This training is often long, challenging and stressful. Understanding the extent of training a career in medicine takes may influence your decision to pursue medicine. To help you understand, let’s walk through the key periods in your journey to becoming a doctor.

High School

We are often asked what high school students need to do to get into medical school. The truth is that there isn’t much you can do. Medical schools don’t look at your high school marks, and most of them will only look at extracurricular activities and volunteer work that you do after you turn 16 years old. However, there are a few things you need to think about in high school.

Are there any specific courses you should take? While medical schools don’t require you to have taken specific high school courses, many of them require certain university courses, and how will you perform in those will be affected by how well you were prepared in high school. Experience in biology, chemistry and physics will help with the university courses and the MCAT required by some medical schools. While not required, we recommend taking the three sciences in Grade 11 and 12 if you are serious about medical school.

In addition, you should work hard to get into the university program of your choice. Do your research early and make sure you have the necessary marks and required high school courses. Also, make sure you spend adequate time when deciding which university to go to. Location, class sizes, course selection, quality of program and other factors are important things to think about. Don’t worry if this is confusing, we will explain this in more detail in a later section.

University

University is when you will do the bulk of your preparation for medical school. This is when your grades start mattering, when most applicants take the MCAT, and when applicants really start building their resume of extracurricular experiences and volunteer work.

Most medical schools require the completion of at least 3 or 4 years of undergraduate studies before being accepted. To clarify, this means that for a medical school that requires 3 years of undergraduate studies before being accepted, an applicant can apply for medical school as early as the beginning of his 3rd year, so that he has 3 years completed by the time he is accepted into medical school at the end of his 3rd year. In the same way, for a medical school that requires 4 years of undergrad, the applicant can apply as early as the beginning of his 4th year.

While many applicants go directly from undergrad to medical school, there are others who complete subsequent degrees (Masters, PhD, etc.) or acquire work experience before being accepted into medical school. Simply put, there is no one path to success in medical school.

Application Cycle

The application cycle for medical schools occurs once a year. An application generally consists of your university courses and grades, MCAT score, essays or supplementary application, and letters of reference. However, keep in mind that not all applications are the same and the requirements are often very different. It is important that you research each medical school in detail and understand their requirements.

Applications are generally due in Oct/Nov. Interview invites are sent in Jan to Mar. Interviews occur in Feb to April. Results are sent out in May.

Most applicants apply to more than one medical school. However, since different medical schools have different requirements, you may be eligible for some but not others. Often times applicants must try several cycles before being accepted.

Medical School

Medical school is usually 4 years long. You spend 2 years in “preclerkship” where most of your time is spent in the classroom learning the basics of anatomy, physiology, medical conditions and treatments, with some exposure to basic clinical skills.

The last 2 years of medical school are spent in “clerkship” where you leave the classroom and work full time in the clinical environment, usually hospitals and clinics. During this period, you are considered a “clinical clerk”. Here you spend anywhere from 1 to 8 weeks rotating through various medical disciplines, such as surgery, internal medicine, paediatrics, psychiatric and so on. In clerkship, you become part of the health care team, working with doctors, residents, nurses, social workers and other health care staff to care for patients.

Residency

When you complete medical school and pass your licensing examination, you acquire your MD degree and are technically a “doctor”. However, all doctors must complete additional training called “residency” to determine what “type” of doctor you will end up being. As you may know, there are many types of doctors – family doctors, neurosurgeons, psychiatrists, etc. All doctors will undergo residency training that helps them become that specific kind of physician. During this period, you are considered a “resident”.

In residency, you will focus on learning more about the diseases and treatments of your field and acquire increasing responsibility in caring for patients until you have obtained enough knowledge, understanding and skills to operate as an independent doctor. Residency can last anywhere from 2 years (family medicine) to 6 years (neurosurgery) depending on the type of doctor you want to be.

How does this all happen? In the fall of your final year of medical school (i.e. your 2nd year of clerkship), you apply to residency programs at different universities (sort of like the medical school process all over again). As with medical school, there are written applications with grades, essays and reference letters, and interviews. And like medical school, there is no guarantee you will get the residency of your choice. Competing against other medical students for the same spots isn’t easy!

Fellowship (optional)

Once you complete residency, you are technically able to start practicing as an independent doctor. However, some doctors wish to develop further specializing in their field of medicine and do an additional 1 or 2 years of training called “fellowship”. During this period, you are considered a “fellow”. For example, a radiologist who reads images (CTs, MRIs, etc.) can do a subspecialty fellowship in neuroradiology and become specialized in reading images of the head, neck and nervous system.

Employment

Once a fully licensed independent doctor, where can you work? There are lots of options. Usually doctors work in hospitals or community clinics. Some work in both. If you work at a teaching hospital (i.e. a hospital affiliated with a university), there are often opportunities to be an educator (e.g. teach medical students and residents) and/or researcher while also practicing as a doctor. The beauty of medicine is that you can have a career that goes beyond the clinical practice of a doctor.

Premed lingo

The previous section on becoming a doctor showed how extensive the journey can be for a career in medicine. From this section onwards, we will get into the nitty gritty about getting into medical school.

However, before we get into details, you must first learn some basic lingo or terminology used in the medical school admissions process. Once you understand these, you will have an easier time reading medical school websites or having discussions with other applicants.

GPA
MCAT
Prequisite courses
Extra-curricular activities
Volunteer work
Research
OMSAS
Reference letters
In-province vs. Out-of-province
Application cycle
Interview
Accepted/Waitlisted/Rejected

Grade Point Average (GPA)

Your GPA is an average of your credit course grades converted to a standardized score, usually out of 4.0. Your undergraduate university usually provides your GPA after each school year, as well as an overall GPA for all of your courses. Medical schools also require your GPA, but they will use their own formulas to calculate them based on your course grades.

Click here  for more information about GPAs and how they relate to medical school admissions.

Medical College Admissions Test (MCAT)

The MCAT is a standardized exam used by many North American medical schools as part of the admissions process. The exam covers several topics, including physics, chemistry, biology, organic chemistry, physiology, reading comprehension, and writing skills.

Click here for more information about the format of the MCAT and tips on how to prepare for it.

Prerequisite courses

Some medical schools do not have any course requirements. However, many medical schools do have a few specific types of university courses you must complete to be eligible for their program – these are called prerequisite courses. Most of these course requirements are reasonable to achieve, and often there is overlap between requirements by different schools.

For example, the University of Toronto’s medical school requires 1 course of the Humanities/Social Sciences/Languages and 2 courses of the Life Sciences. Queen’s University requires 1 Biological Sciences, 1 Physical Sciences, and 1 Humanities/Social Sciences courses. On the other hand, McMaster University’s medical school has no prerequisite courses.

It’s important that you speak with an academic counsellor at your university to identify which of your courses will satisfy those requirements. In addition, keep in mind that you can take your prerequisite courses as late as the year you are applying to the medical school.

Extra-Curricular Activities (ECs)

Extra curricular activities are basically any type of activity you have do or have done with regular commitment outside of your educational curriculum. Common types of ECs include school clubs, social justice groups, music groups, sports teams, visual arts, and so on.

Volunteer Work

While volunteer work could technically fall under the category of ECs, they are generally viewed separately. Volunteer work usually involves activities done for the purpose of serving others at no cost, such as volunteering with hospitals, charities, etc.

Research

When premeds talk about research, they are referring to the non-curriculum activity of working with a scientist supervisor and his/her team to uncover new knowledge or apply current knowledge to produce something new. For premeds, such scientist supervisors are usually university professors or physician researchers working at a teaching hospital or university.

Although ECs, volunteer work and research are not explicitly required by medical schools, they play a significant role in supporting an applicant as a well-rounded individual with many skills beyond academics.

Click here for more information on ECs, volunteer work and research, and what role they play in the medical school admissions process.

Ontario Medical School Application Service (OMSAS)

OMSAS is the online, centralized application service for applying to Ontario medical schools. Other medical schools in Canada must be applied to directly.

Reference letters

Reference letters are written by individuals of authority who have worked with the applicant in a supervisory role and can comment on their academic and non-academic qualities. The individual writing the letter is known as a “referee”. The referee is commonly an academic supervisor (professor, research supervisor, etc.) or a supervisor in an EC (e.g. sports coach), volunteer work (e.g. charity coordinator) or employment (e.g. employer/boss). Medical schools usually require 3 letters of reference.

In-province vs. Out-of-province

In-province (IP) and out-of-province (OOP) are terms that refer to an applicants status when applying to a particular medical school. IP status is usually granted to students who have previously lived in the medical school’s province or who attended the medical school’s university previously. OOP status refers to students applying to a medical school which exists in a province for which they did not live in previously or attend that medical school’s university.

The reason IP/OOP status is important is because some medical schools have specific quotas or application requirements that depend on the student’s IP/OOP status. Usually, IP applicants are advantaged, either with lower application requirements and/or more class spots available. It is important that you check each medical school’s website carefully to determine whether you meet IP status and the application advantages that come with it.

Application cycle

Medical school applications are processed once a year, since a new medical school class is formed every year. Application cycle refers to the process that occurs once a year for one full attempt at applying to medical school. Of course, you can apply to as many medical schools you like at once, as long as you meet their eligibility criteria. It is not uncommon to see applicants who apply to anywhere between 1 and over 10 medical schools in Canada.

One application cycle usually involves the submission of an application (GPA, MCAT, essays, letters of reference) in the fall, followed by interviews in the spring of the following year, and ending with results (accepted/waitlisted/rejected) provided in late spring/early summer.

Interview

Applicants with the top written applications (usually the top 15%-20%) move on to the interview stage. Those who do not receive an interview are considered “rejected pre-interview” and will hopefully receive interviews from other medical schools, or will have to re-apply next year. Keep in mind that because different medical schools look for different things in applicants, it is not uncommon for students to be offered interviews from some medical schools but not others.

The interviews are usually held in “traditional” or “multiple mini interview” format. This is the last component of the admissions process before medical schools rank the applicants and send out admission offers.

Accepted/Waitlisted/Rejected

After medical schools make their decisions on interviewed applicants, there are 3 potential outcomes:

Accepted – the medical school accepts you and you can start your education there in the coming fall. If more than one medical school accepts you, then you can choose which one to attend. Usually medical school offers in Canada occur around the same time.

Waitlisted – applicants who are waitlisted at a medical school have not been accepted, but could potentially be accepted within the next few months depending on how many of the medical school’s initial offers are accepted. This is because it is not uncommon for applicants to be accepted at more than one medical school, and thus once their choice is known, the medical school whose offer was not accepted can offer the now empty spot to the next person on the waitlist.

For example, imagine a medical school that has 100 class spots, with the next top 50 applicants on a waitlist (i.e. 101 to 150 on the ranking list). On the first day, the medical school sends out offers to the top 100 applicants they ranked. After the first week, 90 have accepted and 10 rejected their offers to attend other medical school. Then the medical school can send their offers to the students on the waitlist ranked 101 to 110.

Rejected – applicants who are interviewed but ended up being ranked among the lower group of applicants and are unlikely to get off a waitlist may be “rejected post-interview”. Of course, it is also possible for an applicant to be rejected without receiving an interview – this is called being “rejected pre-interview”.

Medical School Requirements

What are my chances at McMaster? What MCAT score does the University of Toronto require? Is my GPA good enough for UBC? How many years of undergrad do I need to do to be eligible for the University of Calgary?

In the previous section, you learned some of the basic terms and components of the medical school admissions process. In this section, we will get more specific and answer questions like those above.

Word of caution: every medical school is different

However, before we get into those details, we must caution you on one very important point: every medical school is different. While all medical schools are looking for smart, hard working, individuals with excellent interpersonal skills, how they assess for these traits varies. This means that each medical school has different GPA, MCAT requirements (some don’t even require the MCAT!) and prerequisite courses, for example.

In addition, not every student is interested in every medical school. You might live on the West Coast and only be interested in medical schools in British Columbia and Alberta – if that’s the case, you should know those schools’ requirements very well.

One common mistake premeds make is to just go through undergrad wanting to go to medical school but not actually doing their research and seeing what requirements they need to achieve. It’s not uncommon to see a premed deciding to apply to medical school in 4th year and suddenly realize their GPA is too low – if only they knew this earlier, they would have worked harder!

This is why it is very important that you do your research to see what the different requirements at each medical school are, and determine:

  1. What GPA, MCAT, etc. you should aim for to be eligible at specific schools
  2. Or, if you’re close to applying, which medical schools you are actually eligible for
MedHopeful’s medical school requirements chart

Luckily for you, MedHopeful has put together a table with the key requirements for Canadian medical schools.

Download requirements chart

We suggest you print it out or keep the screen open.

Below, we will go through each of the columns from our table and mention some key ideas about these requirements:

School
Name of the medical school

Applicants
Number of applicants to the medical school the previous year

Class size
Number of spots in the upcoming medical school class

Using the Applicants and Class size data, you can calculate a rough estimate of your chances of being accepted (assuming all applicants are equal). For example, the average applicant in 2011 had a (203/3549)*100 = 5.72% chance of getting into McMaster Medical School.

While 5.72% seems like a small chance, keep in mind that most medical students apply to more than one medical school. Since some applicants will actually get in off the waitlist, the probability of getting into McMaster medical school is even higher.

In fact, in 2011, there were 17,978 applications from 5,409 individuals to Ontario medical schools. This means that, on average, an Ontario medical school applicant applied to ~3 medical schools in total, and this does not include the medical schools they applied to outside Ontario.

What does this all mean? Well, data tells us there are 953 medical school spots total in Ontario. Therefore, the probability of the average applicant getting into any Ontario medical school last year was (953/5409)*100 = 17.62%, which is slightly higher than a 1 in 6 chance. While those aren’t fantastic odds, they aren’t completely scary either.

Minimum academic requirement
This column tells you the minimum number of academic years or course credits required for that medical school. These requirements don’t need to be met at the time of application – rather, they need to be met by the time you start medical school. This is an important point to understand, so let’s use an example.

For example, McMaster’s medical school requires 3 full years of undergrad. This means that you can apply as early as the beginning of your 3rd year of undergrad. What this is means, however, is that if you do get into McMaster, your acceptance is contingent on you passing your 3rd year of undergrad.

Prerequisites
This shows any prerequisite courses the medical school requires. Make sure you look at the medical schools that interest you, and then plan out completing them during your undergraduate studies. In addition, speak with your academic counsellor at your university to see which courses satisfy those prerequisite categories. Often students ask us “which course counts as a humanities or social science?” The answer is that it depends on what your university thinks, so ask your own academic counsellors what counts. Usually medical schools aren’t strict with this, as long as it is quite clear from the course title that you have taken a course that is related to the requirement.

Non-academic requirements
This column highlights the non-academic aspects of the application process for each medical school, such as essays or interviews. It does NOT tell you what non-academic experiences (e.g. research, volunteer work, clubs, etc.) are required – this is because there are NO such requirements for medical schools. Medical schools are not going to tell you what ECs to do – that is up to you. However, we will discuss in future sections what types of non-academic experiences are a good idea, to help you do well in the non-academic aspects, such as the interview or essay.

Citizenship
If you are a Canadian citizen or permanent resident, you are eligible for any Canadian medical school. If you are not, it depends on the medical school, and you need to see which.

Interview date
The months the medical school normally holds interviews

MCAT
Whether the MCAT is required for that medical school.

Minimum MCAT
Minimum MCAT score required for that medical school (if there is a minimum).

Minimum GPA
Minimum GPA required by that medical school – keep in mind that for some schools the minimum GPA is enough (schools that use cutoffs, such as Western Ontario) while for others you want to aim for a more competitive GPA than the minimum (such as UofT).

Now that you understand the basics of applying to medical school and some of the requirements, in subsequent sections we will get into more detail about the work you need to do to make yourself a competitive applicant.



Read the rest of the Get Started series: