Gambling on an M.D.

In 2013, most would-be doctors came from just six undergrad schools, even though they were the tougher, more competitive ones

(Photograph by Cole Garside)

(Photograph by Cole Garside)

After a tough first year in the bachelor of medical sciences program at Western University, Parima Saxena thought she might have made the wrong choice. She finished with a 2.8 grade point average (on a four-point scale), the equivalent to a grade in the low 70s. That wasn’t bad for such a tough program, but it was not good enough to give her a shot at medical school, a goal she shares with most of the other 800 students accepted into the program.

Now the president of Western’s pre-med club, Saxena is heading into her fourth and final year. Her grades have recovered and she logged a 3.7 this year, but she still wonders if she might have managed a higher GPA at a different school. She has heard it’s easier to get stellar marks in similar programs at Brock University or the University of Waterloo, for example, because they’re smaller and, therefore, not as competitive. At Waterloo, they take 230 students into the bachelor of biomedical science program each year, with a minimum of 81 per cent, while Western requires marks in the high 80s and low 90s from its much larger first-year class.

For high school students who want to be doctors, one of the most anxiety-provoking decisions is where to get their first degree. After all, the applicant who finishes a bachelor’s with an 87 per cent average may have her pick of medical schools, while someone who achieves 82 per cent might not get into any. Some students find advice in online forums such as PreMed101.com; others ask older students like Saxena. There are plenty of opinions—some swear the University of Toronto’s life sciences is so hard, it should be avoided at all costs—but little data to back up the rumours.

When Maclean’s asked Canada’s 14 English and bilingual medical schools where their first-year M.D. classes had most recently studied, all but three (University of Ottawa, Northern Ontario Medical School and the University of Calgary) answered the request. While the sample is small, there is a pattern that will give those who dream of being a doctor one fewer thing to worry about. MD_CHART

The 1,598 first-year medical students in our 2013 sample completed their undergraduate degrees at 58 Canadian schools, but 1,250 of them—78 per cent—had last studied at one of 15 universities with a medical school on campus. Even more striking was that 833—or 52 per cent—had attended one of six schools: McMaster University, University of Toronto, Western University, McGill University, University of British Columbia and University of Alberta. These are precisely the schools with a reputation among pre-meds for being difficult, suggesting students shouldn’t worry about avoiding them.

Dr. Marc Moreau, assistant dean of admissions at the University of Alberta’s medical school, says that, aside from in-province quotas (85 per cent of first-years must be Albertans), U of A gives no extra weight to any university. But he has a theory about why students think tougher schools will hurt their chances at med school, when the students who attend those same schools are more likely to get in. Although some students will find the University of Lethbridge (where entrance standards are lower and classes are smaller) easier than the University of Alberta (where they’re likely to have more competition for high grades), it won’t necessarily help them in the long run.

“A student at Lethbridge may have an easier time in a physics course than at U of A,” he says, “but you may have a better prof at U of A and do better because that prof makes you work harder.”

Evidence of hard work is something admissions committees are looking for more than ever as they rely less and less on grades. At U of A, grades make up only 30 per cent of the admissions criteria, “and it may be lower next year,” he says. The rest is a combination of things such as the Medical College Admission Test, employment history, awards, evidence of leadership, proof of volunteerism and “diversity of experiences.”

More of the best job opportunities, volunteer positions and “diverse experiences” can be found in larger cities, which happen to be where most of the medical schools are. The student who chooses U of A might get lower grades than if he had gone to a school where there’s less competition, but he may also have more access to medical research internships at teaching hospitals that could impress admissions committees.

That still doesn’t explain why so many undergrads are clustered at just half a dozen schools. Tim He, president of the Medical Direction McGill, a pre-med club, guesses that half of those first-year medical students came from a handful of universities in 2013, because the best and brightest high school students apply mostly to the top-ranking universities. Indeed, five out of six of the schools that medical students are most likely to have attended are ranked in the top six in the Maclean’s University Rankings, and all do well in international competitions.

On top of that, many high school students tend to go places where the entrance requirements are toughest because of the prestige of getting in, says He. McGill’s minimum entrance grade for out-of-province students enrolling in science in 2013 was 92.5 per cent in the top five courses—much higher than the low 80s in six courses needed at Brock or Waterloo. The top students in He’s Calgary high school aimed for U of T, McGill, UBC or Alberta; he applied to all those except U of A, because he wanted to live in another province.

Dr. David Snadden, an executive associate dean at UBC’s medical school, says rankings and entrance grades cause students to cluster at a few schools, not because medical admissions committees prefer them. “We really try not to discriminate in any way about which school people have come from,” Snadden says. While it’s true that UBC’s medical school takes more students from UBC (107 last year) than from the University of Victoria (32) or Simon Fraser University (30), “we have many, many more applications from UBC.” They also take many from McGill (21) and McMaster (14) for the same reason.

So while M.D. students shouldn’t worry about avoiding “hard schools,” they also shouldn’t fret if they haven’t attended one of the six schools where so many have gone before, so long as they’ve done everything they can to round out their education with a rich resumé. A university with a medical school may be a better bet, according to this small, unscientific sample—but, then again, at least 15 came from Acadia University in tiny Wolfville, N.S., another 15 from the University of Regina, and 13 more had studied at the University of Northern British Columbia.

Dr. James Rourke, dean of medicine at Memorial University of Newfoundland, finds students who attended Memorial for their first degree tend to be the top performers in its medical school. Memorial doesn’t discriminate based on school, either, so future doctors should just pick a university where they think they’re going to thrive. “Some do well at a big, bold university like McGill or U of Toronto; some do better at a smaller, more personalized university.”


Gambling on an M.D.

  1. I’m not really surprised that most of the students did their undergrad at a school that also had a med school. If I were to go back and do it all again with the goal of becoming a doctor I’d probably do the same. The chance to get comfortable in a city you may end up doing your MD at or meeting current students (without having to fly across the country) would be the draws for me.

    What I do think would be interesting would be to look at the proportion of students from each school that made it into med school. For example, 39 UofOttawa students is a tiny proportion of the 40,000 or so undergraduates there (admittedly many would not even be thinking med school, but the same applies to all schools), but 15 from Acadia is a much larger proportion of the 4,000 undergraduates there.

  2. The headline of this article should be rewritten to read, ‘Six of the largest Canadian universities produce the most med students in the country.’

    There are 813,650 full-time undergraduate students studying across Canada, and 198,370 (24%) are found at the six institutions topping the chart above. Logic would serve that these schools would generate the most med school applicants (and therefore more accepted students) as they have the lion’s share of the population.

    This article would have been more meaningful if we knew how many people applied to all of the med schools, and from where those applicants graduated. Lacking these numbers, at the very least, it would have been interesting to see how the smaller schools stood up when population/med-school-student-production was taken into account.

    For instance, the combined 2013 full-time undergraduate populations at the three schools at the bottom of the chart (UPEI, St.FX and Trinity Western) was 9,200. Together, they produced 30 med students, vs. the 466 med students that came from the 106,500 undergraduate students at McMaster, UofT and Western. In other words, 0.32% of the students at the lower-producing schools became med students vs. 0.43% students at the top-producing schools. Granted these numbers represent total populations for all years of study, and not just the graduating classes, but the point is that many schools producing fewer med students are simply producing fewer graduates, and likely fewer med school applicants; the raw number of students a university sends to med school does not correlate to a prospective student’s chance of getting into med school if they attend said university.

    All stats came were found via the Association of Universities and College of Canada: http://www.aucc.ca/canadian-universities/facts-and-stats/enrolment-by-university/

  3. There is so much wrong with this that I can’t not comment. If the author had taken a social science course that addressed sampling biases (and some statistics) then he’d recognize the problem. First, as the previous comment indicates, there is nothing surprising about large universities supplying more undergraduates to medical schools; they’re bigger and generate more applicants. What is needed is a variable that is more likely to operate independently of size — e.g., acceptance rate: if (for instance, to use the table above) Concordia had 11 applicants and McMaster had 300 applicants then the students from the former are outperforming the latter (100% acceptance vs <50%), and Medial School applicants would be advised to go to Concordia for it's amazing conversion rate. As it stands, the data used doesn't say much of anything and certainly doesn't support the conclusion. Second, the article is full of misinformation and unsupported claims that courses are more challenging (and high marks are harder to obtain) at larger institutions. On what basis is this claimed? Are smaller universities easier? I've had direct experience of both (as a student and instructor) and I don't believe it is true — and, if anything, the opposite is the case because faculty in smaller institutions are typically more directly involved in the education of their students (not via TAs) and thus are able to direct and demand more from them. As a piece of research, this article would get a C- (only if I were at Lethbridge, I'd give it a B- if I were at UBC!).

  4. The article should have ranked schools based on proportions, or “chances”, of medical school admission, especially when “gambling” is a theme of the article. They only reported absolute counts. Based on both personal and educational consulting experiences, we still remember sitting in the 2000 student lecture halls where most of us indicated a wish to pursue medicine when asked by the professor (the rest were probably dentistry and pharmacy keeners). If we were to repeat undergrad with the goal of “gambling on an MD”, we would not have attended the University of Toronto, which probably would not rank in the top 10 if admission chances were considered, although, to be fair, UofT did offer many scholar and professional networking opportunities that will benefit my medical career. Find out more about med school admissions at mdconsultants.ca.

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