By Jiayi Hu, HBSc, MD

Most medical schools in North America have four-year programs. McMaster University and the University of Calgary in Canada are two notable exceptions, both with a three-year accelerated program with limited summer breaks. In Canada, regardless of your school, the training process is well standardized. In the US, however, there are over 100 schools and the quality of education may be quite variable. You would have to complete the same set of national board exams to be eligible for independent practice in either Canada or the US.

Typically, the first half of the medical school curriculum involves mostly didactic lectures with relatively limited patient exposure. This time, block is usually called “pre-clerkship” and it has the goal of building a strong knowledge foundation in the mechanisms, manifestations, and management of various diseases. Other topics that are commonly covered include anatomy, histology, and embryology.

The second half of medical school is termed “clerkship,” during which all students complete clinical rotations and participate in patient care for integrated clinical learning. The core rotations include internal medicine, surgery, family and community medicine, obstetrics and gynaecology, paediatrics, and psychiatry. Other core rotations may include anaesthesia, emergency medicine, ophthalmology, or otolaryngology, depending on the school.

Other than core rotations, students also have elective rotations during which they have the opportunity to complete rotations in any specialty. This is either for career exploration or to prepare one for residency applications in their specialty of interest. It is usually a three-month period with rotation every two weeks (individual schools may vary).

During the last year of medical school, students apply for residency positions, which determine their future specialty of practice. In Canada, there are usually over 2,000 domestic applicants per year for roughly the same number of residency spots 23. At the same time, there is also a similar volume of international applicants (those who trained abroad and are Canadian permanent residents or citizens) for only one tenth of the available spots. Different specialties also have varying levels of competitiveness. Generally speaking, over 90% of domestic applicants match to a spot, and over 70% can obtain their first choice specialty, but not necessarily at their first choice school21. Should a medical student not be successful in the matching process, one can still participate in the second and final round of applications (the second match), or wait until the next application cycle. Most career counselors advise students to apply broadly in the first round to avoid disappointment, as the second match round is significantly more competitive.

23 Canadian Resident Matching Services.

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