Production of this report has been made possible

through a financial contribution from Health Canada.

The views expressed herein do not necessarily

represent the views of Health Canada.

Project team:
Sandra Banner, team leader and site visitor;
Ashley McKiver, project manager and researcher;
Sara Rattanasithy, data analyst;
Josephine Cassie, site visit collaborator;
Christel Woodward, survey tool consultant;
Rebecca Ford, editor.
TABLE OF CONTENTS
BACKGROUND ..................................................................................... 5
EXECUTIVE SUMMARY ....................................................................... 6
SUMMARY OF RESULTS ...................................................................... 7
RESULTS ................................................................................................ 8
SAMPLE ................................................................................................. 8
Table 1 – Breakdown of 2010 sample by region ............................ 8
Table 2 – Medical school of respondents ........................................ 8
DEMOGRAPHIC INFORMATION ....................................................... 9
Figure 1 – Age by medical school region ....................................... 9
Figure 2 – Age: CSA vs. CMG .................................................... 10
Figure 3 – Gender by medical school region.................................. 10
Figure 4 – 2010 and 2006 gender and age comparison 2010 ...... 11
Figure 5 – Gender comparison: CSA vs. CMG ............................... 11
MARITAL STATUS ................................................................................. 12
Figure 6 – Marital status by medical school region ........................ 12
Figure 7 – Marital status by gender ................................................ 12
Figure 8 – Marital status: CSA vs. CMG ......................................... 13
CSAs WITH PARENTS AS PHYSICIANS ............................................ 13
Figure 9 – CSAs with one or more parents who are physicians ..... 13
Figure 10 – CSAs with parents who are physicians by region ....... 13
Comparison of the 2010 CSA study to the 2010 Canadian
medical graduate cohort ................................................................ 14
PRE-MEDICAL EDUCATION ................................................................ 14
Figure 11 – Province of residence before moving abroad ............. 14
Projected number of CSAs by province ........................................... 14
Figure 12 – Comparing province of residence of survey
respondents to provincial medical school admission rates
and provincial baseline statistics....................................................... 14
CANADIAN POST-SECONDARY EDUCATION ................................. 15
Table 3 – Top five reported post-secondary schools attended
by CSAs ............................................................................................. 15
Figure 13 – Post-secondary education in Canada by medical
school region..................................................................................... 15
Figure 14 – Highest level of education prior to attending a
medical school abroad ..................................................................... 15
Highest level of education by medical school region...................... 16
Figure 15 – Highest level of education prior to attending
medical school: CSA vs. CMG.......................................................... 16
Figure 16 – Number of times CSAs applied to Canadian
medical schools prior to studying medicine abroad........................ 16
Figure 17 – Number of times CSAs applied to Canadian
medical schools prior to studying medicine abroad by region .......... 17
Comparison of the 2010 CSA study to the 2010 Canadian
medical graduate cohort ............................................................... 17
STUDYING MEDICINE ABROAD ........................................................ 17
Figure 18 – Motivation to study medicine abroad.......................... 17
Figure 19 – Criteria for choosing a medical school abroad............ 18
CaRMS Report: 2010
Figure 20 – How CSAs learned about medical school abroad ...... 18
Figure 21 – Year of graduation from medical school...................... 19
Figure 22 – Year of graduation by medical school region.............. 19
Figure 23 – Satisfaction with medical degree program.................. 20
Figure 24 – Satisfaction with medical degree program by
medical school region....................................................................... 20
CLERKSHIPS .......................................................................................... 21
Figure 25 – Difficulty in arranging a clerkship rotation in
Canada by medical school region.................................................... 21
Figure 26 – Number of clerkship rotations done or confirmed
in Canada by medical school region ............................................... 21
Comparison of the 2006 pilot CSA study to the 2010 CSA study .. 22
FUNDING............................................................................................... 22
Table 4 – Most popular funding types for medical school abroad..... 22
Figure 27 – Most popular funding types by medical school region... 22
Table 5 – Top funding source by region and medical school ......... 22
DEBT ....................................................................................................... 23
Estimated total amount of debt ....................................................... 23
Figure 28 – Median debt by medical school region....................... 23
Comparison of the 2010 CSA study to the 2010 Canadian
medical graduate cohort ................................................................ 23
Figure 29 – Satisfaction with cost of medical education ................ 23
Figure 30 – Satisfaction with cost of medical education
by medical school region.................................................................. 24
Table 6 – Annual tuition rates........................................................... 24
POSTGRADUATE PLANS .................................................................... 25
Figure 31 – Intention to return to Canada to pursue
postgraduate medical training ......................................................... 25
Figure 32 – Intention to stay in Canada to practice medicine
after Canadian postgraduate training .............................................. 25
Table 7 – Year of graduation from medical school by intention
to return to Canada to pursue postgraduate medical training ....... 25
Table 8 – Region of medical school by intention to return to
Canada to pursue postgraduate medical training........................... 26
Comparison of the 2006 pilot CSA study to the
2010 CSA study ............................................................................... 26
FIRST/TOP CHOICES ............................................................................ 26
Table 9 – Intending to return for postgraduate training in Canada:
first choice locations for postgraduate medical training in Canada ..... 26
Table 10 – Intending to return to postgraduate training in Canada:
top choice disciplines for postgraduate medical training in Canada ... 27
Comparison of the 2006 pilot CSA study to the
2010 CSA study .................................................................................. 28
Table 11 – Top five locations for postgraduate medical
training in Canada (CSA vs. CMG) .................................................. 28
Table 12 – Top five disciplines for postgraduate medical
training in Canada (CSA vs. CMG) ................................................... 28
CANADIANS NOT INTENDING TO RETURN TO CANADA
FOR POSTGRADUATE MEDICAL TRAINING.................................... 29
Figure 33 – Perceived barriers to returning to Canada for
postgraduate training ...................................................................... 29
3
 Table 13 – Reasons for not intending to return to Canada
for postgraduate medical training by region ................................... 30
Figure 34 – Country (if not Canada) where CSAs intend to
complete their postgraduate medical training ............................... 30
Figure 35 – Intention to return to Canada to practice medicine
after postgraduate medical training abroad .................................... 30
Figure 36 – Perceived barriers to returning to Canada to
practice medicine after postgraduate medical training abroad ..... 31
Comparison of the 2006 pilot CSA study to the
2010 CSA study .............................................................................. 31
INTERNATIONAL MEDICAL SCHOOL DATA
BY MEDICAL SCHOOL ........................................................................ 31
CARIBBEAN
Table 14 – Caribbean medical school data website sources ......... 31
Table 15 – Number of CSAs studying medicine in the Caribbean ... 32
Table 16 – General information ....................................................... 33
Table 17 – Admissions by medical school ....................................... 33
Table 18 – Curriculum summary by medical school ....................... 38
Table 19 – Accreditation by medical school ................................... 42
Table 20 – Tuition by medical school .............................................. 44
Table 21 – Clerkships by medical school ........................................ 44
AUSTRALIA ..................................................................................... 46
Table 22 – Australian medical school data website sources .......... 46
Table 23 – Number of CSAs studying medicine in Australia ......... 46
Table 24 – General information ...................................................... 46
Table 25 – Admissions by medical school ...................................... 47
Table 26 – Curriculum summary by medical school ....................... 49
Table 27 – Accreditation by medical school ................................... 51
Table 28 – Tuition by medical school .............................................. 51
Table 29 – Clerkships by medical school ........................................ 52
IRELAND ......................................................................................... 52
Table 30 – Irish medical school data website sources..................... 52
Table 31 – Number of CSAs studying medicine in Ireland ............ 52
Table 32 – General information ....................................................... 53
Table 33 – Admissions by medical school ...................................... 53
Table 34 – Curriculum summary by medical school ....................... 54
Table 35 – Accreditation by medical school ................................... 55
Table 36 – Tuition by medical school .............................................. 55
Table 37 – Clerkships by medical school ........................................ 55
POLAND........................................................................................... 56
Table 38 – Polish medical school data website sources ................. 56
Table 39 – Number of CSAs studying medicine in Poland ............ 56
Table 40 – General information ...................................................... 57
Table 41 – Admissions by medical school ...................................... 57
Table 42 – Curriculum summary by medical school ....................... 58
Table 43 – Accreditation by medical school ................................... 60
Table 44 – Tuition by medical school .............................................. 60
Table 45 – Clerkships by medical school ........................................ 60
UNITED KINGDOM (UK) ............................................................... 61
Table 46 – UK medical school data website sources .................... 61
Table 47 – General information ...................................................... 61
Table 48 – Admissions by medical school ...................................... 62
Table 49 – Curriculum summary by medical school ...................... 66
4
Table 50 – Accreditation by medical school ................................... 66
Table 51 – Average tuition by medical school ............................... 66
Table 52 – Clerkships by medical school ........................................ 67
EUROPE/MIDDLE EAST ................................................................ 68
Table 53 – Europe/Middle East medical school data
website sources ................................................................................ 68
Table 54 – Number of CSAs studying medicine in
Europe/Middle East ......................................................................... 68
Table 55 – General information ...................................................... 68
Table 56 – Admissions by medical school ...................................... 69
Table 57 – Curriculum summary by medical school ....................... 69
Table 58 – Accreditation by medical school.................................... 71
Table 59 – Tuition by medical school............................................... 71
Table 60 – Clerkships by medical school ........................................ 71
INTERNATIONAL MEDICAL SCHOOL DATA –
MEDICAL SCHOOL SURVEY RESULTS ............................................. 72
SURVEY RESPONDENTS .............................................................. 72
Table 61 – Location of survey respondents .................................... 72
Table 62 – Role of survey respondents ........................................... 72
MOTIVATION TO RECRUIT INTERNATIONAL MEDICAL
STUDENTS REGIONS OF RECRUITMENT ................................... 73
Table 63 – Factors that influence the number of international
students trained ............................................................................... 73
Factors that influence the number of international students
trained by medical school region ................................................. 73
Table 64 – Intention to change the size of international
medical training programs ............................................................... 74
Intention to change the size of international medical training
programs by medical school region ............................................. 74
Table 65 – Expected changes in legislation that will impact
international medical training programs ......................................... 74
Expected changes in legislation that will impact international
medical training programs by medical school region ................ 74
MEDICAL DEGREE PROGRAMS AND ADMISSION
REQUIREMENTS BY MEDICAL SCHOOL REGION ................... 75
Table 66 – Available medical degree programs and admission
requirements by medical school region .......................................... 75
Admission procedures ................................................................... 75
Table 67 – Additional admission procedures by region of
medical school ................................................................................. 75
Table 68 – Do admissions criteria differ for international
students versus national students? .................................................. 76
Admissions committee .................................................................. 76
Table 69 – Admissions committee representatives ........................ 76
TUITION ........................................................................................... 76
Table 70 – Average yearly tuition..................................................... 76
POSTGRADUATE TRAINING ........................................................ 77
REFERENCES......................................................................................... 77
APPENDIX – ANALYSIS RESULTS ................................................. 78
CaRMS Report: 2010
BACKGROUND
Canada’s doctor to patient ratio is among the lowest of any
industrialized nation.1 Despite a 69.0% increase in medical school
enrolment,2 Canadians continue to perceive a doctor shortage.
The applicant pool for medical school remains unchanged in the
last decade with four qualified applicants for every admitted
medical school student in Canada.2 Over the past decade, and
perhaps due to these factors, there has been a recognized and
increasing subset of Canadians who have chosen to pursue
medical education abroad. Although these Canadians appear to
be increasing in number and have begun to have a political voice,
little is known about their true numbers, demographics, motiva-
tion to study abroad, general characteristics or whether they are
interested in returning to Canada. This study was developed to
provide a description of this potential resource and to help inform
the provincial and federal governments for future physician re-
source planning. The definition of a Canadian studying abroad
(CSA) recognizes that while these individuals are international
medical graduates (IMGs), they are Canadians who left Canada
to pursue their dream of medical education abroad. They are
citizens born in Canada, or permanent residents. Almost all of
them have done some of their earlier education in Canada, but
choose to go abroad for medical education. This definition
separates these individuals from other international physicians
(IMGs), who graduate abroad prior to coming to Canada and
becoming citizens or permanent residents.
CaRMS Report: 2010
The Canadian Resident Matching Service (CaRMS) administers
the match into postgraduate training in Canada. CaRMS was the
first Canadian medical organization to identify this growing
cohort of CSAs seeking entry into the Canadian healthcare
system. In 2005-2006 Sandra Banner, the Executive Director and
CEO of CaRMS, conducted a brief survey of select CSA schools
and applicants. This study was based only on informal discussions
among some of the international medical schools identified at a
point when the medical community estimated that there were
approximately 400 students studying medicine outside of North
America. The results of this survey estimated that there were
approximately 1500 Canadian students studying medicine
abroad.3 Since 2006, the project team has identified additional
international schools and an increasing number of CSAs who
were used to form the study population for this report. Where
possible, the results in this report are compared to data from the
2006 report.
CSAs were identified using several data sources including: the
CaRMS 2008 and 2009 applicant databases, a list of schools
provided by the Medical Council of Canada (MCC), using data
from graduates of international institutions applying for MCC’s
evaluating examination (a prerequisite for residency training in
Canada). Using this methodology, 55 schools outside of North
America were identified as having Canadian students studying at
them. Each school was contacted and asked to distribute a letter
to their Canadian students. The letter outlined the scope of the
study and provided the online student survey link with password.
The online student survey was available from August 2009
through to June 2010. Each institution was also asked to com-
plete a school survey and if they were willing to host a site visit.
5
 EXECUTIVE SUMMARY
Canadians studying abroad are spread across the globe from
Australia to China to the Netherlands. What they have in common
is their desire to come home to Canada to practice medicine.
Canadian students who are unsuccessful in being admitted to a
Canadian medical school, and make the decision to go abroad to
a foreign medical school do so largely because they believe there
is a shortage of physicians in Canada, and there will be opportuni-
ties for them to return to Canada to practice medicine.
While provincial health human resource planning regulates admission
to medical schools in Canada, and federal citizenship and immigration
regulates the number of immigrants to Canada, there are no
regulations that will allow for a prediction of the number of Canadian
students who will choose to study medicine abroad and return to
Canada for postgraduate training and practice.
The number of CSAs has grown exponentially since 2000. The
estimated number has more than doubled since the first survey
in 2006.3 As the majority of Canadians are enrolled in programs
with a duration of four years, the output of these international
medical schools could contribute almost 700 graduates per year
(equal to the total number of graduates each year in all medical
schools west of Ontario), or nearly 30% of the total Canadian
medical school output. Furthermore, this study indicates that
more schools are opening enrolment to international students
each year. CSAs are studying medicine in schools all over the
world—today approximately 80 schools in almost 30 countries
are identified as having Canadian students enrolled in medicine.
However, most people are only familiar with schools in Ireland,
Australia, the Caribbean and most recently, Poland. This study
found that every year, new schools are emerging, offering
international students the opportunity to study medicine. The
majority of these programs target North American students, who
are prepared to pay the high tuition fees for the opportunity to
become physicians. The medical education they are receiving is
as diverse as the countries themselves. There is no typical CSA, as
there is no typical immigrant IMG. Both have studied medicine in
education systems that have differing curriculums, resources and
patient populations. Often, immigrant IMGs have graduated from
the same schools that CSAs are graduating from.
In countries where the native language is English, international
students are integrated into classes with national students.
Among the non-profit schools that were visited in this study,
international students were valued for their diverse backgrounds,
unique perspectives, and as a significant revenue source for the
medical school.
In some countries, international students are taught in English in
a parallel curriculum to the national students who are taught in
their native language. International students are given the
opportunity to learn the language, but translators are provided
during their clinical rotations so that they can experience direct
patient contact in the hospitals and clinics. This is the case for
schools offering international medical programs to North Ameri-
can students in Poland, the Czech Republic, Romania, Hungary
and Bahrain, just to name just a few.
Although most schools visited in the study had some sort of
national accreditation, it varied considerably from a peer review,
6
to a site visit of the curriculum, to a government-led overall
education standard across all of the professional education
institutions not specific to medicine. The educational curriculum
varied across all schools visited, and the clinical component of the
students’ undergraduate medical education did not usually offer
the autonomy and direct patient care of the North American
medical education model.
Demographically, the majority of CSAs continue to be male,
slightly older, single and with more post-secondary education
than their medical student counterparts in Canada. CSAs on
average have more debt than CMGs—CSAs have nearly $90,000
more debt than students in Canadian medical schools,7 though
many cite funding from family savings as a source of support for
their education. This study found that more CSAs have a medical
doctor as a parent than were identified in a study of Canadian
medical graduates (CMGs).4 The majority of CSAs are residents of
British Columbia and Ontario where the success rates of
medical school applicants are the lowest.5
While some students have entered into their international
medical school directly from high school, most CSAs have not
applied to Canadian medical schools as many times as the
successful student studying in Canada.5 This suggests that due
to their age and higher education, CSAs opt to study abroad
because they have decided they would not be successful in
Canada, or would rather not wait several years to be successful
in their Canadian medical school applications.
CSAs express frustration in their attempts to arrange Canadian
clinical rotations while in their undergraduate years abroad. The
inability to obtain clinical experiences during their undergraduate
education has increased between the survey in 2006 and 2010,3
and may result from the increased domestic enrolment and the
perceived lack of capacity to provide these experiences to
anyone other than Canadians studying in Canada. The Caribbean
school respondents reported the most difficulty, while respon-
dents from Australia and Ireland continue to report some success,
suggesting that a lack of capacity may not be the entire reason
for not obtaining clerkship opportunities.
While most CSAs (over 90%) want to return to Canada for
postgraduate training, they report frustration with the perceived
barriers to pursuing postgraduate education in Canada. These
barriers include: choice of discipline, return of service, and the high
competition for positions. While Canada has a ubiquitous shortage
of family physicians, particularly in rural communities, only 21% of
CSAs choose a career in family medicine. However, they have very
few, if any, opportunities to complete postgraduate training in the
country where they are studying medicine. None of the for-profit
schools in the Caribbean have postgraduate training opportunities,
and the schools that recruit Canadian students in Ireland, Poland,
other European countries and Australia have little or no postgraduate
opportunities available for international students.
Admission data provided by the schools and the international
Canadian student organizations led to an estimation of about
3500 Canadian students enrolled in medical schools abroad.
CaRMS Report: 2010
SUMMARY OF RESULTS
Survey results
• 32 of the 55 schools (58.2%) agreed to distribute the student
survey, 20 (36.4%) answered the institutional survey and
16 (29.1%) agreed to site visits. This represents a four times
greater response rate than the original survey in 2006.3
• 1082 students completed the online survey (approximately a
30.3% response rate, based on estimated enrolment).
• Students studying in Irish medical schools had the highest
response rate (41.8%).
• The majority of CSAs (46.3%) were found in Caribbean schools.
Cohort demographics
• Overall there was a higher percentage of male students
(52.5%) enrolled in international medical schools than males
in Canadian medical schools (41.8%).5
• Irish medical schools were the exception, with 57.0% female
students, which is similar in composition to Canadian medical
schools which average 58.2% female students.5
• Overall, CSAs are older than students in Canadian medical
schools, 73.9% of CSAs are 26-30 years old while only 46.4%
of Canadian medical graduates (CMGs) are the same age.6
• A higher percentage of CSAs are single (83.1%) compared to
students studying medicine in Canada (61.6%).6
• CSAs were more often children of physicians, with 21.0%
reporting one or more of their parents as medical doctors
compared to 15.6% of CMGs.4
• CSAs whose parents are physicians were more likely to
attend medical school in Ireland.
• The majority of CSAs come from the provinces of British
Columbia and Ontario.
Entry into medical school
• 5.9% of CSAs entered medical school from high school.
• Despite some CSAs entering medical school directly from
high school, more CSAs have advanced degrees than
students in Canada, 13.1% of CSAs reported master’s
degrees, while 9.8% of CMGs reported the same level of
education.5
• CSAs applied to Canadian medical schools an average of
1.76 times while CMGs applied 2.59 times before being
successful.5
• 26.7% of CSAs had never applied to a Canadian medical school.
• The most frequently reported reason for choosing an
international medical school was students felt they would be
unable to secure a place in a Canadian school.
Cost, debt and satisfaction
• The average annual tuition cost ranges from $12,250(CAD) in
Poland to $66,369(CAD) in Australia.
• Site interviews revealed that international students are
important revenue sources for not only the for-profit universities
but also the non-profit state universities. In the latter cases,
CSAs’ tuition supplements the national medical education costs.
• The CSA median debt is $160,000(CAD) compared to the
2007 CMG median debt of $71,000(CAD).7
CaRMS Report: 2010
• CSAs with lower reported median debt reported higher
satisfaction with the cost of their medical education.
Educational process, choices and perceived barriers to
postgraduate education
• A smaller percentage of respondents in this survey reported
success negotiating clinical type clerkship experiences than
respondents in the 2006 survey.3
• Respondents from Australia and Ireland were more successful
than the respondents from the Caribbean in arranging
Canadian clerkships.
• 90.3% of the respondents reported a desire to return to
Canada for a portion of their postgraduate medical
education, and 24.8% reported a plan to return to Canada
after postgraduate training abroad. Only 67.2% of respondents
in the 2006 survey indicated their intention to return to
Canada for postgraduate training.3
• In both the 2006 and 2010 surveys, the further away the
respondents were from graduation, the more likely they were
to respond that they intended to return to Canada.3
• The main barriers cited regarding the return to Canada for
postgraduate medical training were:
- The requirement to provide “return of service” for the
postgraduate experience.
- The choice of discipline was difficult to obtain.
- The perception that they would have difficulty matching
to a program in Canada.
• The top two career choices of CSAs continue to be Family
Medicine and Internal Medicine, similar to the 2006 survey.3
• The top two university choices were the University of Toronto
and the University of British Columbia.
Limitations
The following limitations have been identified:
• Respondent bias—as analysis has been done on self-
reported data.
• The findings are also subject to non-response bias, as well as
low response bias. As an example, it was difficult to compare
the Middle East to all other areas surveyed, as the response
rate was much smaller. This made it difficult to project any
true trends for that area.
• Non-participation—the study was subject to the international
medical schools’ willingness to participate. Without the aid
of the schools, it proved to be very difficult to contact and
recruit participation of Canadian students.
• The findings are limited by having little access to
Canadian students from the Caribbean medical schools,
especially those in their clinical years.
• Faculty and students likely wanted to present their schools
in the best possible light.
• There was no incentive to complete the surveys.
• At the beginning of the study, only 55 of the more than
75 schools where Canadians are now known to be studying
medicine abroad were identified, as more schools are
discovered every day.
7
 RESULTS
SAMPLE

Statistical analysis
In total, 1082 CSAs completed the survey. From these respondents,
a summary of demographic information was conducted, followed
by an analysis of pre-medical education, current experience with
medical education, and postgraduate plans. The respondents were
also grouped according to the geographic region of their medical
school to determine if there were notable differences across
geographic regions. The Pearson chi-square test of independence
was used to look for relationships between variables. Further, differ-
ences in proportions were tested using the z-test for proportions.
A p value < 0.05 was regarded as being significant.

TABLE 1 BREAKDOWN OF 2010 SAMPLE BY REGION * Three respondents listed as attending a

medical school in the UK were included in
Medical School Survey Estimation of CSAs Enrolled in Medical this group as there were not enough
respondents to create a separate group
Region Respondents Schools Across all Years of Study
for analysis.
Ireland* 272 650 ** Two respondents listed as attending a
Poland** 79 300 medical school in the Czech Republic and
one survey respondent listed as attending
Caribbean 501 2000 a medical school in Romania were included
Australia 206 550 in this group.
***Middle East group includes respondents
Middle East*** 23 70 attending a medical school in Bahrain
Totals 1081 3570 and Israel.

Note: one respondent was excluded from the regional analysis because they were from an international medical school not
contacted for this study, and not within any of the regions contacted.

TABLE 2 MEDICAL SCHOOL OF RESPONDENTS

Medical School Region n %

St. George’s University Caribbean 233 21.5%
Saba University School of Medicine Caribbean 187 17.3%
University of Queensland Australia 114 10.5%
Royal College of Surgeons in Ireland Western Europe 104 9.6%
University of Sydney Australia 52 4.8%
Jagiellonian University Medical College Eastern Europe 50 4.6%
Ross University Caribbean 47 4.3%
Trinity College, University of Dublin Western Europe 46 4.3%
University College Dublin Western Europe 46 4.3%
University College Cork Western Europe 32 3.0%
University of Limerick Western Europe 30 2.8%
Poznan University of Medical Sciences Center Eastern Europe 24 2.2%
Flinders University of South Australia Australia 19 1.8%
RCSI Bahrain Middle East 12 1.1%
Sackler School of Medicine Middle East 11 1.0%
University College, Galway Western Europe 11 1.0%
American University of the Caribbean School of Medicine Caribbean 10 0.9%
Xavier University School of Medicine, Bonaire Caribbean 10 0.9%
University of Wollongong Australia 8 0.7%
University of Melbourne Australia 7 0.6%
James Cook University Australia 6 0.6%
Windsor University Caribbean 6 0.6%
All Saints University School of Medicine, Dominica Caribbean 3 0.3%
Continued on page 9
CaRMS Report: 2010
8
 TABLE 2 MEDICAL SCHOOL OF RESPONDENTS

Medical School Region n %

International American University College of Medicine Caribbean 2 0.2%
University of Sint Eustatius Caribbean 1 0.1%
Spartan Health Sciences University Caribbean 1 0.1%
IAU College of Medicine Caribbean 1 0.1%
Medical University of Warsaw Eastern Europe 1 0.1%
Medical University of Silesia, School of Medicine in Katowice Eastern Europe 1 0.1%
St. Georges University Western Europe 1 0.1%
University of Manchester Western Europe 1 0.1%
University of Nottingham Western Europe 1 0.1%
Other 4 0.4%
Total 1082 100%
* Other includes schools in: Chile, Romania, and the Czech Republic

DEMOGRAPHIC INFORMATION

Age
The average age of CSAs is 26 years old, with a range of 18 years old to 46 years old.

AGE BY MEDICAL SCHOOL REGION

80%
24 & under
72.3%
70% 25-29
59.5% 60.9%
60% 30-34
54.4%
35 & over
50%
46.7%
43.5%
40% 39.1%
36.8%
30% 30.4%

20%
10.2% 13.1%
10% 8.1% 8.9% 7.6%
1.3% 2.2% 4.4%
0.7%
0%
Ireland Poland Carribean Australia Middle East

Figure 1 Age by medical school region

When examining the age of CSAs in relation to their region of study, it was found that Australia had a significantly older
population than any other region.

CaRMS Report: 2010

9
 Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

AGE COMPARISON

* Source: CaRMs 2010 CMG

Cohort Data
100% 20-25
73.9% 26-30

50% 31-40
45.3% 46.4%
41-50
10.6% 14.8%
7.7%
0.6% 0.6%
0%
CSA CMG

Figure 2 Age: CSA versus CMG

By increasing the age of the CSA respondents to reflect their true age at graduation, they could then be compared to the Canadian
medical graduate cohort of 2010. It was found that only 10.6% of CSAs are under 25, compared to 45.3% of CMGs. While 91.7% of
CMGs are under 30, twice as many CSAs are older than 30. Overall, the CSA cohort is older than the CMG cohort.

Gender
Overall, males made up 52.5% of the respondents and females accounted for the remaining 47.5%.

GENDER BY MEDICAL SCHOOL REGION

60%
57.0% 56.3% 55.3% Male
54.4% 52.2%
50% 47.8% Female
43.0% 45.6% 44.7%
43.7%
40%

30%

20%

10%

0%
Ireland Poland Carribean Australia Middle East

Figure 3 Gender by medical school region

A higher percentage of men studying abroad than women was found in every region surveyed, with the exception of Ireland, where
there were 14.0% more women studying medicine than men.

CaRMS Report: 2010

10
Comparison of the 2006 pilot CSA study to the 2010 CSA study

Gender and age comparison

2010 CSAS: GENDER BY AGE 2006 CSAS: GENDER BY AGE

100%
100% 100%
Male Male
80% Female Female
80% 77.3%
70.0%
66.7% * Source:
60% 51.5% 58.9% 60% 55.8% CaRMS
51.3% 52.3%
50.0% 2006 CSA
40% 44.2% 50.0% Report
48.7% 48.5% 40%
41.1% 47.7%
20% 30.0% 33.3% 20%
22.7%
0% 0.0%
0%
24 & 25-29 30-34 35 & 45 & 24 & 25-29 30-34 35 & 45 &
Under Over Over Under Over Over

Figure 4 2010 and 2006 gender and age comparison

In the 2006 pilot study, it was found that females were more likely to fall into the youngest age category while males where twice as
likely to be 30 years of age or older. However, the 2010 study revealed that no significant differences existed in the age groups when
compared by gender.

Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

Gender comparison

GENDER CSA VERSUS CMG

100%
100% Male CSA * Source: Canadian Medical
Female Education Statistics 2009,
80%
80%
70.0% CMG* The Association of Faculties
66.7% of Medicine of Canada
60%
60% 51.3% 51.5% 58.9% 58.2%
52.5%
47.5%
40%
40% 48.7% 41.8%
48.5%
41.1%
20%
20% 30.0% 33.3%

0%
0%
24 & 25-29 Male
30-34 35 & 45 & Female
Under Over Over

Figure 5 Gender comparison: CSA versus CMG

It is interesting that the proportions are nearly reversed in the two data sets. More men are studying medicine abroad, while more
women are studying medicine in Canada. The only region that is similar in composition to Canada is Ireland, where 57.0% of students
studying abroad were women. See the Appendix for full details of analysis results.

CaRMS Report: 2010

11
 MARITAL STATUS

The majority (83.1%) of CSAs are single, separated or divorced, while only 16.9% are married/living with a partner.

The majority (81.5%) of CSAs did not have family members or a partner living abroad with them during their medical education. Only 18.5%
of CSAs reported having family members or a partner living with them abroad full-time or occasionally during their medical education.

MARITAL STATUS BY MEDICAL SCHOOL REGION

100%
91.3% Single
90% 85.0%
85.7% 82.3%
80% Married/Living
with a partner
70% 70.9%
Separated/
60% Divorced
50%
40%
30% 28.2%
20% 17.7%
14.3% 14.0%
10% 8.7%
0.0% 0.0% 1.0% 1.0% 0.0%
0%
Ireland Poland Carribean Australia Middle East

Figure 6 Marital status by medical school region

Overall, Australia had the highest percent (28.2%) of Canadians studying abroad who were married/living with a partner.
This may be a result of these students generally being older. See the Appendix for full details of analysis results.

MARITAL STATUS BY GENDER

100%
90% Male
81.5% 83.5%
80% Female
70%
60%
50%
40%
30%
20% 17.8% 16.0%
10% 0.7% 0.6%
0%
Single Married/Living Separated/
with partner Divorced

Figure 7 Marital status by gender

This analysis concluded that neither males nor females are more likely to be married/living with a partner while studying abroad.

CaRMS Report: 2010

12
 Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

Marital status comparison

MARITAL STATUS: CSA VERSUS CMG

100%
* Source: CaRMs 2010
90% Single/Divorced CMG Cohort Data
83.1% Separated/Widower
80%
70% Married/Living with partner
61.6%
60%
50%
40% 38.4%
30%
20% 16.9%
10%
0%
CSA CMG

Figure 8 Marital Status: CSA versus CMG

While only 16.9% of CSAs are married/living with a partner, theopposite trend is true for Canadian medical students, where a
significantly greater proportion (38.4%) is married/living with a partner.

CSAs WITH PARENTS WHO ARE PHYSICIANS

CSAs WITH ONE OR MORE PARENTS WHO CSAs WITH ONE OR MORE PARENTS WHO ARE PHYSICIANS BY REGION
ARE PHYSICIANS
90%
84.2% 82.6% Yes
81.1%
80% No
77.2%
Yes,
70% 68.0%
one
17.2% parent
60%
Yes,
3.8% both 50%
parents
No 40%
32.0%
79.0% 30%
22.8%
20% 18.9% 17.4%
15.8%
10%

n=1082 0%
Ireland Poland Carribean Australia Middle East

Figure 9 CSAs with one or more parents who are physicians Figure 10 CSAs with parents who are physicians by region

Of the 21.0% of CSAs that have one or more parents as a Students who have one or more parents who are physicians are almost
medical doctor, 42.5% are family physicians, while 57.5% twice as likely to choose to study medicine in Europe—specifically
are specialists. Ireland—rather than the Caribbean. See the Appendix for full details of
analysis results.

CaRMS Report: 2010

13
 Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

CSAs with one or more parents who are physicians

As reported in the Canadian Medical Association Journal (CMAJ), 15.6% of today’s Canadian medical students have a physician
parent.4 In comparison, 21% of CSAs have at least one parent who is a physician.

PRE-MEDICAL EDUCATION

PROVINCE OF RESIDENCE BEFORE MOVING ABROAD

0.4% NL
1.2% 2.8%
PE
1.1%
3.6% NS
NB
18.6% QC
ON
MB
10.5% SK
AB
57.8% BC
1.9%
2.1%

Figure 11 Province of residence before moving abroad

86.9% of Canadians studying abroad are residents of three of the 10 Canadian provinces, with 57.8% residents of Ontario, 18.6% residents of
British Columbia and 10.5% residents of Alberta.

Projected number of CSAs by province

This survey indicates that there are approximately 3500 Canadian students studying medicine abroad, with as many as 500 coming
from British Columbia and over 1500 from Ontario.

COMPARING PROVINCE OF RESIDENCE OF SURVEY RESPONDENTS TO PROVINCIAL MEDICAL SCHOOL

ADMISSION RATES AND PROVINCIAL POPULATION BASELINE STATISTICS
70%
Survey respondent’s * Source: Canadian
60% Medical Education
province of residence (%)
50% Statistics 2009, The
Success rate of applicants (%) Association of Faculties
40% of Medicine of Canada
Population baseline** (%) ** Source: 2009 Population
30%
by Province, Statistics
20% Canada

10%
0%
NL PE NS NB QC ON MB SK AB BC

Figure 12 Comparing province of residence of survey respondents to provinical medical school admission rates and provincial baseline statistics

This graph shows that Ontario and British Columbia have the greatest population when compared to the other Canadian provinces.
They also have the highest number of residents who choose to study medicine abroad. Furthermore, Ontario, British Columbia and
Prince Edward Island have the lowest rate of successful medical school applicants. Therefore, the increased frequencies at which
Ontario and British Columbia students choose to study medicine abroad may be a direct response to the lower success rates of
medical school applicants, and larger population baselines in Ontario and British Columbia.

CaRMS Report: 2010

14
CANADIAN POST-SECONDARY EDUCATION

Post-secondary education
A total of 90.3% of CSAs attended a post-secondary institution in Canada prior to attending an international medical school.
The University of Toronto was the most attended Canadian institution for post-secondary education among the survey respondents.

TABLE 3 TOP FIVE REPORTED POST-SECONDARY SCHOOLS ATTENDED BY CSAS

Post-Secondary School Province n %

University of Toronto Ontario 170 17.4%
The University of Western Ontario Ontario 105 10.8%
The University of British Columbia British Columbia 93 9.5%
McMaster University Ontario 88 9.0%
McGill University Quebec 68 7.0%

POST-SECONDARY EDUCATION IN CANADA BY MEDICAL SCHOOL REGION

100% 98.1%
93.8% Yes
90% 87.0%
80.5% 83.5%
80% No
70%
60%
50%
40%
30%
20% 19.5%
16.5% 13.0%
10% 6.2%
1.9%
0%
Ireland Poland Carribean Australia Middle East

Figure 13 Post-secondary education in Canada by medical school region

Respondents from the Caribbean and Australia where more likely to have attended a post-secondary institution in Canada than those
whose medical school was in Europe, where admission to medical school is available directly from high school.

HIGHEST LEVEL OF EDUCATION PRIOR TO ATTENDING MEDICAL SCHOOL ABROAD

Ph.D., or Equivalent 1.6%

Master’s degree 13.1%

Bachelor’s degree 73.7%
3 years or more of university 1.9%
2 years or less in university 2.8%
Post -secondary 0.4%
High school 5.9%
Other 0.6%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Figure 14 Highest level of education prior to attending a medical school abroad

In 2010, 88.4% of respondents indicated that they had a bachelor’s degree, master’s degree or Ph.D prior to attending an international
medical school. Only 5.9% reported receiving only a high school diploma prior to studying abroad.
CaRMS Report: 2010
15
 Highest level of education by medical school region
When comparing the highest level of education of respondents
based on the geographic region of their medical schools, Australian
students and Caribbean students were the most likely to have com-
pleted a bachelor’s degree prior to studying abroad. The proportion
of students who had attained master’s degrees was the highest in
Australia (14.6%), comparable to the Caribbean where 13.4% of
respondents had attained master’s degrees and Ireland, where
13.6% have a master’s. In Poland, just 5.1% of students reported
having postgraduate degrees prior to studying abroad.

Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

HIGHEST LEVEL OF EDUCATION PRIOR TO ATTENDING MEDICAL SCHOOL

80%
73.7% CSA
70%
60.9% CMG
60%
50%
* Source:
40% CaRMs 2010
30% CMG Cohort
Data
20%
14.5% 13.1% 9.8%
10% 5.9% 7.1%
0.8% 0.4% 2.8% 3.7% 1.9% 1.6% 2.9% 0.6% 0.3%
0%
High College 2 years or 3 years+ Bachelor’s Master’s Ph.D. or Other
School less in university Degree Degree equivalent
university (no degree)
(no degree)

Figure 15 Highest level of education prior to attending medical school: CSA versus CMG
Although a greater number of CSAs than CMGs enter medical school directly from high school, CSAs are significantly more educated
than CMGs when entering medical school.

APPLICATION TO CANADIAN MEDICAL SCHOOLS

APPLICATION TO CANADIAN MEDICAL SCHOOLS

40%
37.0%
35%
30%
25% 26.7% 23.6%
20%
15%
10% 9.3%

5%
1.9% 0.9%
0% 0.1% 0.1% 0.1% 0.1% 0.1% 0.1%

Did not 1x 2x 3x 4x 5x 6x 7x 8x 9x 10x 13x

apply
Number of Times Applied

Figure 16 Number of times CSAs applied to Canadian medical schools prior to studying medicine abroad
.A total of 37.0% of CSAs applied only once to Canadian medical schools, while approximately the same number of CSAs applied two
or more times to Canadian medical schools prior to studying abroad. Interestingly, 26.7% did not apply to any Canadian medical
schools prior to studying abroad. Of the CSAs that did not apply to any Canadian medical schools before going abroad, there is a
significant difference in their highest level of education. For CSAs that had a high school education before going abroad, 95.3% did
not apply to any Canadian medical schools, while 20.8% of CSAs with a bachelor’s degree did not apply to any Canadian medical
schools. See the Appendix for full results.

CaRMS Report: 2010

16
 APPLICATION TO CANADIAN MEDICAL SCHOOLS BY MEDICAL SCHOOL REGION

60%
54.4% Did not
50% 49.0% apply
43.1% Applied
40% once
38.2%
34.8% 34.8% Applied 2x
32.7% 33.3% 31.6%
30% 29.0% 29.1% 30.4% or more
23.6%
20% 19.4%
16.5%
10%

0%
Ireland Poland Carribean Australia Middle East

Figure 17 Number of times CSAs applied to Canadian medical schools prior to studying medicine abroad by medical school region

Almost half of the respondents from Australia applied multiple times to Canadian medical schools prior to leaving to study medicine
abroad. In contrast, 54.4% of the respondents from Poland had never applied to a Canadian medical school prior to deciding to study
medicine abroad, 27.9% cited their reason as being able to enter medical school directly from high school, while 20.9% cited that
they were unable to gain acceptance into a Canadian medical school.

Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

Application to Canadian medical schools

Canadian students studying medicine abroad on average applied to Canadian medical schools 1.76 times prior to enrolling in a foreign
medical school. In contrast, Canadian students studying at Canadian medical schools, on average, apply 2.95 times prior to being admitted.5

STUDYING MEDICINE ABROAD

MOTIVATION TO STUDY MEDICINE ABROAD

80% Unable to obtain a place in a 77.6%

Canadian medical school 73.7% CSA
70%
Allowed me to enter medical school 60.9%
60% directly from secondary school 7.8% CMG
50% 6.6%
Wanted to live in another country
40%
Tuition costs were lower than 1.8%
30% Canadian medical school
20% My family was living in this 0.5%
14.5% 13.1% 9.8%
10% foreign country currently
5.9% 2.8% 3.7% 7.1%
0.8% 0.4% 5.8% 1.9% 1.6% 2.9% 0.6% 0.3%
0% Other
High College 2 years or 3 years+ Bachelor’s Master’s Ph.D. or Other
School less in university Degree Degree equivalent
0%
university 10% 20%
(no degree) 30% 40% 50% 60% 70% 80%
(no degree)

Figure 18 Motivation to study medicine abroad

Overall 77.6% of CSAs reported that their main reason for choosing to study abroad was because they were unable to obtain a place in a
Canadian medical school. A total of 1.8% reported it was due to lower tuition costs.

CaRMS Report: 2010

17
 CRITERIA FOR CHOOSING A MEDICAL SCHOOL ABROAD

Reputation (n= 1082) * Participants were able

88.6% to select more than
Likelihood of obtaining some one answer.
clerkships in North America 77.4%
(n= 1082)
Course taught in a language 51.1%
I understand (n= 1082)
Cost (n= 1082) 35.6%

Attractiveness of country (n= 1082) 32.0%

Proximity to Canada (n= 1082)) 8.2%

Other (n= 1082) 7.1%

0% 20% 40% 60% 80% 100%

Figure 19 Criteria for choosing a medical school abroad

Reputation was the most important factor in choosing a medical school abroad, while the opportunity for clerkships in North America
came in a close second. This may be an advantage in recruitment strategies of medical schools in the Caribbean, where all of the
medical schools make use of hospitals in the US for their clerkship training.

HOW CSAs LEARNED ABOUT MEDICAL SCHOOL ABROAD

From a friend/relative/graduate * Participants were able

72.7% to select more than
from school (n=1082)
one answer.
Searched on internet (n=1082)) 40.6%

Attended the school’s presentation

18.0%
in Canada (n=1082))
School’s advertisement posted 6.4%
in a university (n=1082)
Newspaper/magazine 4.2%
article (n=1082)
Other (n=1082)) 7.4%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Figure 20 How CSAs learned about medical school abroad

The majority (72.7%) of CSAs learned about their medical school from a friend/relative or graduate from the school,
while only 18.0% attended the school’s presentation in Canada.

CaRMS Report: 2010

18
 YEAR OF GRADUATION FROM MEDICAL SCHOOL

2010 11.7%
2011 15.4%
2012 28.0%
2013 32.0%
2014 11.9%
2015 0.9%

0% 5% 10% 15% 20% 25% 30% 35%

Figure 21 Year of graduation from medical school

The vast majority of respondents are in a four year medical program. 72.8% of the respondents will be graduating between 2012
and 2014, which places them in the early years of their medical education. 19.1% are completing five or more years of study. This may
reflect the 7.8% who chose a medical school abroad on the basis that they could enter directly from high school. It also speaks to the
large proportion who did not apply in Canada at all.

YEAR OF GRADUATION BY MEDICAL SCHOOL REGION

50%
45.7%
2010
45%
2011
40% 38.0%
39.1%39.1% 2012
35% 35.9% 2013
32.0% 2014
30% 28.3% 29.1%
27.2%
2015
25.3%
25%
20.6%
20%
17.6%
16.5%
15% 14.0%
13.9%
11.8% 11.8% 11.2%
10% 8.7% 8.7%
5.3%
5% 4.6% 4.3%
3.8%
2.2% 2.5% 2.4%
0.4% 0.0% 0.0%
0%
Ireland Poland Carribean Australia Middle East

Figure 22 Year of graduation by medical school region

Overall, the Australian respondents were the closest to graduation (2010-2012), while the majority of students in Ireland, Poland,
and the Caribbean were further from graduation and expected to graduate between 2012 and 2014. The Caribbean had the lowest
percent of respondents expected to graduate between 2010 and 2012. This may be due to the fact that the third and fourth year
students attending medical school in the Caribbean are currently dispersed across the United States doing clerkships. It was difficult
to find a clerkship coordinator to notify the clinical clerks about this survey. The exception was St. George’s in Grenada, where the
clerkship dean assisted in the notification of students.

CaRMS Report: 2010

19
 SATISFACTION WITH MEDICAL DEGREE PROGRAM

1.9% Very Satisfied

0.6%
5.5%
Satisfied
Neutral
40.5%
Dissatisfied
51.4%
Very Dissatisfied

Figure 23 Satisfaction with medical degree program

Overall, 91.9% of survey respondents reported being satisfied and/or very satisfied with the medical education they
are receiving abroad.

SATISFACTION WITH MEDICAL DEGREE PROGRAM BY MEDICAL SCHOOL REGION

100%
93.4% 92.4% 93.6%
90% 87.0%
85.9% Satisfied
80%
Neutral
70%
Dissatisfied
60%
50%
40%
30%
20%
13.0%
10% 6.3% 8.7%
4.4% 2.2% 4.4% 2.0% 5.3% 0.0%
1.3%
0%
Ireland Poland Carribean Australia Middle East

Figure 24 Satisfaction with medical degree program by medical school region

Canadians studying in the Caribbean reported being the most satisfied (93.6%) with their medical degree program, while those
studying in Ireland were also highly satisfied (93.4%). A total of 92.4% of CSAs in Poland reported overall satisfaction, while 85.9% of
CSAs in Australia reported the same satisfaction. Although students studying in Australia tend to be more critical of their medical
education, some considerations leading to these results may be that they are older and slightly better educated. Proportionally, the
Australian respondents were also further along in their medical education, either in their third or fourth years of study.

CaRMS Report: 2010

20
CLERKSHIPS

Only 22.6% (n=244) of the respondents were in a clerkship year. When surveyed on the difficulty of arranging clerkships in
Of these respondents, 69.1% (n=168) reported that they had tried Canada, 55% found it difficult to very difficult, while only 18.6%
to arrange a clerkship rotation in Canada. reported it to be easy or very easy. The remaining respondents
were neutral on the matter of arranging a clerkship in Canada.

DIFFICULTY IN ARRANGING A CLERKSHIP ROTATION IN CANADA BY MEDICAL SCHOOL REGION

90%
82.5% Easy
80%
Okay
70%
Difficult
60%
50% 48.9%
44.8%
41.7%
40%
33.3%
30% 28.4% 29.8%
26.9% 25.0%
20% 17.5%
21.3%
10%
0.0%
0%
Ireland Poland Carribean Australia

Figure 25 Difficulty in arranging a clerkship rotation in Canada by medical school region

Overall, 82.5% of respondents from the Caribbean reported that it was difficult to arrange a clerkship in Canada. A total of 48.9%
of Australian respondents felt the same way. See the Appendix for full details of analysis results.

NUMBER OF CLERKSHIP ROTATIONS DONE OR CONFIRMED IN CANADA BY MEDICAL SCHOOL REGION

100%
96.8%
90% 87.3% 95.7% Yes, done
79.0% 80.1%
80% Yes, confirmed
70% No
60%
50%
40%
30%
20%
11.0% 9.9% 13.6%
10% 8.9% 6.3%
3.8% 1.4% 1.8% 4.3%
0.0%
0%
Ireland Poland Carribean Australia Middle East

Figure 26 Number of clerkship rotations done or confirmed in Canada by medical school region

A total of 20.9% of CSAs in Ireland reported that they had done or confirmed a clerkship in Canada. A total of 19.9% of CSAs in Australia
also reported having done or confirmed a clerkship in Canada, while only 12.7% from Poland, 3.2% from the Caribbean and 4.3% from
the Middle East reported having done or confirmed a clerkship in Canada. These numbers are comparable to Figure 25 which shows how
difficult it is to arrange a clerkship in Canada. Regions that reported a high difficulty in arranging a clerkship displayed the lowest numbers
of clerkships done or arranged in Canada, while regions that reported having done or arranged clerkships in Canada felt they were easier
to arrange. This result could be an indication of bias for students in Ireland and Australia over students in other regions.

CaRMS Report: 2010

21
 Comparison of the 2006 pilot CSA study to the 2010 CSA study

Overall, a lower percentage of respondents in 2010 reported having likely to have completed or arranged a clerkship in Canada.3
successfully arranged a clerkship in Canada. In 2010, students from The 2006 and 2010 studies both found that CSAs studying in the
Australia reported the most clerkships arranged or completed in Caribbean were the least likely to have completed or arranged a
Canada, while in 2006, CSAs studying in Europe were the most clerkship in Canada.3

FUNDING

TABLE 4 MOST POPULAR FUNDING TYPES FOR MEDICAL SCHOOL ABROAD

FUNDING TYPE % The most popular type of funding for medical school reported by CSAs was
Family savings 70.3% family savings, followed by bank loans and government grants in Canada.
However, as Table 4 shows, CSAs do not use just one source to fund their
Bank loan in Canada 69.1%
medical school abroad, but tend to use a combination of sources. When
Government grants – Canada 37.6%
looking at the average CSA, 44.0% of their total funding to attend an
Personal savings 31.2% international medical school is from a bank loan, 37.0% is from family
Bank loan elsewhere 6.6% savings, and only 1.0% is from an international scholarship.
International scholarship (study abroad grant) 7.8%
* Survey respondents were able to select more than one answer.
Other 6.8%

MOST POPULAR FUNDING TYPES BY MEDICAL SCHOOL REGION

50%
Family Savings
40% Bank Loan in Canada
30% Government Grants
Personal Savings
20%
International Scholarships
10% Bank Loan Elsewhere
0% Other
Ireland Poland Carribean Australia Middle East

Figure 27 Most popular funding types by medical school region

Family savings was cited as the main funding source more frequently by CSAs in Europe and the Middle East than CSAs in the Caribbean or
Australia. A higher percentage of CSAs in Australia and the Caribbean reported that they funded their education through a bank loan in Canada.

TABLE 5 TOP FUNDING SOURCE BY REGION AND MEDICAL SCHOOL

Region Medical School Top Funding Source % Average Yearly Tuition ($CAD)

Ireland Royal College of Surgeons Family Savings 95.2% 63,051

Trinity College, University of Dublin Family Savings 78.3% 41,809
Poland Jagiellonian University Medical College Bank Loan in Canada 66.0% 15,780
Poznan University of Medical Sciences Center Family Savings 70.8% 12,911
Caribbean St. George’s University Bank Loan in Canada 74.1% 62,232
Saba University School of Medicine Bank Loan in Canada 79.1% 27,178
Australia University of Queensland Bank Loan in Canada 71.9% 54,571
University of Sydney Family Savings 82.7% 53,112
Middle East RCSI Bahrain Family Savings 83.3% 38,245
Sackler School of Medicine Personal Savings 45.5% 28,644

CaRMS Report: 2010

22
DEBT

Estimated total amount of debt

Over half of CSAs reported their estimated amount of debt to be debt to be less than $100,000, 54.4% estimated their debt to be
above $160,000 (CAD). In fact, the most frequent estimated between $100,000 and $299,999 and 14.9% estimated their debt
amount of debt cited was $200,000 (CAD). However, 12.2% of to be $300,000 or greater.
CSAs did not expect to have any debt, 30.7% estimated their

MEDIAN DEBT BY MEDICAL SCHOOL REGION

$250,000
$200,000 $200,000
$200,000
$175,000
$150,000

$100,000 $90,000
$70,000
$50,000

$0
Ireland Poland Carribean Australia Middle East

Figure 28 Median debt by medical school region

Overall, CSAs studying in Ireland and Australia reported the highest ($200,000 CAD) total estimated median debt at graduation, while
$175,000 (CAD) was the median debt reported by CSAs studying in the Caribbean. A much lower median debt of $70,000 (CAD) and
$90,000 (CAD) was reported by those studying in Poland and the Middle East.

Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

Median debt

The median debt reported by CSAs in 2010 was $160,000 (CAD). The median debt of Canadians has risen $31,000 (CAD) since
In comparison, an article from Medical Education, which surveyed 2001,7 however it is still $89,000 (CAD) less than the median
Canadian medical students in 2001 and 2007, reported the debt of Canadians studying medicine abroad.
median debt of Canadian medical graduates as $71,000 (CAD).7

SATISFACTION WITH COST OF MEDICAL EDUCATION

11.7%
15.6%
Very Satisfied 11.7%
18.3% Satisfied 15.6%
Neutral 22.7%

31.6% Dissatisfied 31.6%

22.7% Very Dissatisfied 18.3%

Figure 29 Satisfaction with cost of medical education

Almost 49.9% of CSAs reported being dissatisfied or very dissatisfied with the cost of their medical education.
CaRMS Report: 2010
23
 SATISFACTION WITH COST OF MEDICAL EDUCATION BY MEDICAL SCHOOL REGION

100% Very satisfied

80% Satisfied
Neutral
60% Dissatisfied
43.0% 52.2% Very dissatisfied
44.1% 42.2%
40% 34.9% 35.4%
23.8%22.6%25.1% 26.7% 23.3% 21.7%
20% 19.5% 17.4%
17.8% 10.8%
16.5%
1.5% 5.1% 6.8% 4.3% 4.3%
1.0%
0%
Ireland Poland Carribean Australia Middle East

Figure 30 Satisfaction with cost of medical education by medical school region

CSAs in Ireland and Australia were the most dissatisfied with the cost of their medical education. Coincidentally, these two regions also
have the highest reported median debts. CSAs in Poland were the most satisfied with the cost of their medical education, and also
reported the lowest median debt per any region surveyed.

When significance testing was run, it was determined that the cost of medical education is related to reported satisfaction with a medical
program. CSAs that were very dissatisfied with the cost of their education reported lower levels of satisfaction with their medical programs
than CSAs that were very satisfied with the cost of their medical education.

Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

TABLE 6 ANNUAL TUITION RATES

Medical School Region Avg. Yearly Tuition ($CAD) Range of Yearly Tuition Fees ($CAD) * Source: Canadian Medical
Education Statistics 2009,
Lowest in Region Highest in Region The Association of Faculties
of Medicine of Canada, 2009
Ireland $49,800 $41,809 $63,051
Poland $14,191 $12,250 $15,780
Caribbean $25,608 $9,017 $62,232
Australia $42,334 $18,894 $66,369
Middle East $26,336 $15,117 $38,244
Canada $12,214* $6,130* $18,586*

CaRMS Report: 2010

24
POSTGRADUATE PLANS

INTENTION TO RETURN TO CANADA TO PURSUE INTENTION TO STAY IN CANADA TO PRACTICE

POSTGRADUATE MEDICAL TRAINING MEDICINE AFTER CANADIAN POSTGRADUATE
MEDICAL TRAINING

9.7%
Yes, all of my 11.8%
Yes
postgraduate
16.9% training No
0.7%
Yes, a portion of Undecided
my postgraduate
73.4% training
No
87.4%

Figure 31 Intention to return to Canada to pursue postgraduate Figure 32 Intention to stay in Canada to practice medicine after
medical training Canadian postgraduate training

Overall, 90.3% of CSAs reported that they intended to return to
Canada to pursue at least some of their postgraduate medical
training. Less than 10.0% reported that they do not intend to
return to Canada for postgraduate training.
A total of 87.4% of CSAs who intend to pursue postgraduate
medical training in Canada also intend to stay in Canada to
practice after this training. Of the 0.7% who stated they do not
intend to stay in Canada after Canadian postgraduate training,
reasons included: limited opportunities to practice in my
preferred location (57.1%), economic incentives to leave Canada
(28.6%), and family considerations (28.6%).

TABLE 7 YEAR OF GRADUATION FROM MEDICAL SCHOOL BY INTENTION TO RETURN TO CANADA

TO PURSUE POSTGRADUATE MEDICAL TRAINING
Year of Graduation Intention to Return to Canada for Training

Yes No Total
n % n % n %
2010 98 77.8% 28 22.2% 126 100%
2011 146 87.4% 21 12.6% 167 100%
2012 281 92.7% 22 7.3% 303 100%
2013 317 91.6% 29 8.4% 346 100%
2014 125 96.9% 4 3.1% 129 100%
2015 9 90.0% 1 10.0% 10 100%
Total 976 105 1081

For CSAs intending to return to Canada to pursue postgraduate medical training, there is a statistically significant difference between
CSAs graduating in 2010 and CSAs graduating in 2014. The further CSAs are from graduating, the more likely they report that they plan
on returning to Canada for postgraduate medical training. CSAs closer to graduation may be more realistic about the challenges of
returning to Canada to pursue postgraduate medical training.

CaRMS Report: 2010

25
 TABLE 8 REGION OF MEDICAL SCHOOL BY INTENTION TO RETURN TO CANADA
TO PURSUE POSTGRADUATE MEDICAL TRAINING
Region of Medical Intention to Return to Canada for Training
Significance testing revealed that all regions
Schools
Yes No Total containing CSAs report an equal likelihood
n % n % n % of planning to return to Canada to pursue
Ireland 255 93.8% 17 6.3% 272 100% postgraduate medical training.
Poland 65 82.3% 14 17.7% 79 100%
Caribbean 454 90.6% 47 9.4% 501 100%
Australia 182 88.3% 24 11.7% 206 100%
Middle East 20 87.0% 3 13.0% 23 100%
Total 976 105 1081

Comparison of the 2006 pilot CSA study to the 2010 CSA study

Intention to return to Canada to pursue postgraduate
medical training
It is important to note that in 2006, only 67.0% of CSA
respondents indicated their intention to return to Canada for
postgraduate medical training3. In 2010, 90.3% of CSA respon-
dents indicated that they intended to return to Canada for
postgraduate medical training. This is a significant increase (176%)
in an intention to return home (z = 11.41, p < .001).
Year of graduation from medical school by intention to return
to Canada to pursue postgraduate medical training
Both the 2010 and the 2006 pilot study noted that being further
from graduation increased the likelihood of a CSA’s intention to
return to Canada for postgraduate medical training.3
Region of medical school by intention to return to Canada to
pursue postgraduate medical training
Although in the 2010 study, no significant differences were found
pertaining to CSAs’ intent to return home by the region of medical
school they were enrolled in, the 2006 pilot study found that
significant differences existed amongst the medical schools. Over
three-quarters of CSAs in European medical schools were planning
to return to Canada, compared to 57.0% (just over half) of those
studying in Caribbean medical schools.3

FIRST/TOP CHOICES

TABLE 9 INTENDING TO RETURN FOR POSTGRADUATE TRAINING IN CANADA:

FIRST CHOICE LOCATIONS FOR POSTGRADUATE MEDICAL TRAINING IN CANADA
First Choice Locations n %

University of Toronto 327 33.5% The University of Toronto ranked first among
University of British Columbia 162 16.6% 33.5% of CSAs as their first choice location for
postgraduate medical training. The University
The University of Western Ontario 59 6.0%
of British Columbia was cited as the first
McMaster University 54 5.5%
choice location for 16.6% of CSAs. This
University of Manitoba 36 3.7% corresponds with the increased number of
University of Calgary 31 3.2% CSAs declaring their province of residence to
Dalhousie University 29 3.0% be Ontario and British Columbia.
University of Alberta 28 2.9%
University of Ottawa 27 2.8%
McGill University 24 2.5%
University of Saskatchewan 20 2.0%
Northern Ontario School of Medicine 11 1.1%
Memorial University of Newfoundland 10 1.0%
* Only includes respondents intending to return to
Queen's University 6 0.6%
Canada for all or part of their postgraduate training.
Not decided 153 15.7%
Total* 977 100.0%

CaRMS Report: 2010

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 TABLE 10 INTENDING TO RETURN TO POSTGRADUATE TRAINING IN CANADA:
TOP CHOICE DISCIPLINES FOR POSTGRADUATE MEDICAL TRAINING IN CANADA
First Choice Discipline n %

Family Medicine 205 21.0% Family Medicine was the first choice residency
Internal Medicine 141 14.4% discipline with (21.0%), followed by Internal
Medicine (14.4%). Yet, 18.1% of respondents
Pediatrics 86 8.8%
remained undecided on their residency
Emergency Medicine 66 6.8%
discipline of choice.
General Surgery 63 6.4%
Orthopedic Surgery 47 4.8%
Obstetrics & Gynecology 36 3.7%
Cardiac Surgery 19 1.9%
Anesthesiology 18 1.8%
Neurology 18 1.8%
Psychiatry 16 1.6%
Diagnostic Radiology 15 1.5%
Neurosurgery 11 1.1%
Radiation Oncology 11 1.1%
Ophthalmology 10 1.0%
Plastic Surgery 9 0.9%
Dermatology 4 0.4%
Urology 4 0.4%
Otolaryngology 3 0.3%
Physical Medicine & Rehabilitation 3 0.3%
Community Medicine 2 0.2%
General Pathology 2 0.2%
Hematological Pathology 2 0.2%
Neurology – Pediatric 2 0.2%
Anatomical Pathology 1 0.1%
Laboratory Medicine 1 0.1%
Medical Genetics 1 0.1%
Other 4 0.4%
* Only includes respondents intending to return to
Not decided 177 18.1% Canada for all or part of their postgraduate training.
Total* 977 100.0%

CaRMS Report: 2010

27
 Comparison of the 2006 pilot CSA study to the 2010 CSA study

Top choice disciplines for postgraduate medical first choice discipline of 19.0% of respondents, followed by
training in Canada Family Medicine at 16.8%.3 Conversely, in 2010, Family Medicine
Family Medicine and Internal Medicine remained the top two was the first choice discipline of 21.0% of respondents, followed
discipline choices for CSAs. In 2006, Internal Medicine was the by Internal Medicine with 14.4% of respondents.

Comparison of the 2010 CSA study to the 2010 Canadian medical graduate cohort

TABLE 11 TOP FIVE LOCATIONS FOR POSTGRADUATE MEDICAL TRAINING IN CANADA (CSA VS. CMG)

CSA CMG*
Top Five Locations n % Top Five Locations n %
University of Toronto 327 33.5% University of Toronto 285 15.7%
University of British Columbia 162 16.6% University of British Columbia 274 15.1%
The University of Western Ontario 59 6.0% University of Montreal 154 8.5%
McMaster University 54 5.5% University of Ottawa 135 7.4%
University of Manitoba 36 3.7% University of Laval 112 6.2%
Total 977 65.3% Total 1814 52.9%
* Source: CaRMs 2010 CMG Cohort Data

The University of Toronto is the first choice among 33.5% of CSAs and 15.7% of CMGs. Both CSAs and CMGs also cite the University
of British Columbia as a top choice.

TABLE 12 TOP FIVE DISCIPLINES FOR POSTGRADUATE MEDICAL TRAINING IN CANADA (CSA VS. CMG)

CSA CMG*
Top Five Disciplines n % Top Five Disciplines n %
Family Medicine 205 21.0% Family Medicine 614 33.4%
Internal Medicine 141 14.4% Internal Medicine 238 12.9%
Pediatrics 86 8.8% Pediatrics 113 6.1%
Emergency Medicine 66 6.8% Anesthesiology 98 5.3%
General Surgery 63 6.4% General Surgery 97 5.3%
Total 977 57.4% Total 1838 63.1%

* Source: CaRMs 2010 CMG Cohort Data

Four out of the five top residency choices for both CSAs and CMGs are the same.

CaRMS Report: 2010

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 CANADIANS NOT INTENDING TO RETURN TO CANADA FOR POSTGRADUATE MEDICAL TRAINING

PERCEIVED BARRIERS TO RETURNING TO CANADA FOR POSTGRADUATE TRAINING

I prefer not to do return of service work 61.0%

My first choice of residency is difficult to obtain in Canada 57.1%

The opportunity to do postgraduate
training in my preferred location is limited 46.7%

I do not think that I have a reasonable 43.8%

chance to match in Canada
I have personal commitments in another country 14.3%

The cost of examinations is too high 6.7%

My career/residency is not found in Canada 5.7%

I do not think I have a reasonable chance of passing
the Medical Council of Canada Evaluation Examination 1.0%

Other 26.7%

0% 10% 20% 30% 40% 50% 60% 70% 80%

* Respondents could select more than one answer. n=105

Figure 33 Perceived barriers to returning to Canada for postgraduate training

Of the 9.7% of CSAs who do not plan to enter postgraduate medical training in Canada, 61.0% reported not wanting to do return of
service work. The other major barriers reported were difficulty in obtaining a first choice residency, and/or location of residency.
43.8% of this group stated they did not intend to return to Canada because they didn’t feel they had a reasonable chance of
matching. This is similar to the 26.7% of CSAs who self-selected themselves out of the competition for admittance to undergraduate
Canadian medical schools by never applying.

Some of the barriers received in the ‘Other’ category included:

• “I think that there are more opportunities available in the States than in Canada especially for foreign medical graduates.”
• “The process seems too complex with too many steps. In the US, USMLE steps 1, 2 and 3 are easy to understand and follow.”
• “Poor working conditions as a doctor in Canada.”
• “In Australia, I will be paid for overtime and on-call work and earn more per hour than if I returned to Saskatchewan,
which offers limited IMG positions.”

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 TABLE 13 REASONS FOR NOT INTENDING TO RETURN TO CANADA FOR POSTGRADUATE TRAINING BY REGION

Medical School Region

Reason
Ireland Poland Caribbean Australia Middle East Total
n % n % n % n % n % n %
I prefer not to do return of service work 10 20% 12 29% 22 21% 19 26% 1 17% 64 23%
My first choice of residency is difficult to obtain 13 27% 10 24% 20 19% 15 20% 2 33% 60 22%
in Canada

The opportunity to do postgraduate training in 10 20% 8 19% 20 19% 10 14% 1 17% 49 18%
my preferred location is limited

I do not think that I have a reasonable chance to 7 14% 6 14% 24 23% 9 12% 0 0% 46 17%
match in Canada

I have personal commitments in another country 4 8% 0 0% 3 3% 6 8% 2 33% 15 5%

The cost of examinations is too high 0 0% 0 0% 5 5% 2 3% 0 0% 7 3%
My career choice/residency is not found in Canada 1 2% 1 2% 1 1% 3 4% 0 0% 6 2%
I do not think I have a reasonable chance of passing 0 0% 1 2% 0 0% 0 0% 0 0% 1 0%
the Medical Council of Canada Evaluating Examination

Other 4 8% 4 10% 10 10% 10 14% 0 0% 28 10%

The majority of respondents studying in Ireland who do not intend to return to Canada for postgraduate medical training cited a
difficulty in obtaining their first choice of residency as their main reason not to return. Those studying in Poland and Australia prefer
not to do a return of service, and those in the Caribbean do not think they have a reasonable chance of matching in Canada.
Respondents in the Middle East also preferred not to do a return of service, and also cited personal commitments in another country
as their reasons for not wanting to return.

COUNTRY (IF NOT IN CANADA) WHERE CSAS INTEND TO INTENTION TO RETURN TO CANADA TO
COMPLETE THEIR POSTGRADUATE MEDICAL TRAINING PRACTICE MEDICINE AFTER POSTGRADUATE
MEDICAL TRAINING ABROAD
2.0% 1.0%
2.9%
77.5%

United Sates Yes

16.7% 24.8%
Australia No
Ireland Undecided
53.3%

Norway 21.9%

n = 102
n = 102

Figure 34 Country (if not Canada) where CSAs intend to complete their
postgraduate medical training
A total of 77.5% of CSAs that do not intend to return to Canada to
pursue postgraduate medical training intend to pursue training in
the United States. However, with a targeted increase of 30% in US
undergraduate admissions and no increase planned for postgraduate
training opportunities, fewer positions will be available to international
medical graduates, requiring these students to explore different
options for postgraduate training.8
Figure 35 Intention to return to Canada to practice
medicine after postgraduate medical training abroad
Of the 9.7% of Canadians who cited they did not intend to
return to Canada for postgraduate medical training, 24.8%
of them do intend to return to Canada after postgraduate
training abroad, while 53.3% remain undecided.

CaRMS Report: 2010

30
 PERCEIVED BARRIERS TO RETURNING TO CANADA TO PRACTICE MEDICINE
AFTER POSTGRADUATE MEDICAL TRAINING ABROAD

Economic incentives to stay away 52.2%

Limited opportunity to practice 52.2%

in my preferred location

Difficulty in obtaining recognition of training 43.5%

Family considerations 21.7%

Limited research funding available in my field 8.7%

Other 21.7%

0% 10% 20% 30% 40% 50% 60%

n = 23 * Respondents could select more than one answer.

Figure 36 Perceived barriers to returning to Canada to practice medicine after postgraduate medical training abroad

This study found that CSAs choose not to return to Canada for postgraduate medical training and practice mainly due to economic
incentives to stay abroad, and limited opportunities to practice in a preferred location. The level of difficulty in obtaining recognition of
training was also cited as one of the main barriers for not intending to return to Canada to practice after postgraduate training abroad.

Comparison of the 2006 pilot CSA study to the 2010 CSA study

Perceived barriers to returning to Canada for postgraduate training

CSAs in both the 2010 and 2006 studies cited the difficulty to
obtain their first choice of residency as a common reason for not
intending to return to Canada for postgraduate training.3 Two
additional reasons from 2006 were: “Foreign-trained graduates
are poorly treated” and “Restriction to the second iteration of
CaRMS poses difficulties”.3 It should be noted that after the 2006
pilot study was completed, the rules changed, and for the first
time, IMGs were allowed to compete in the first iteration of the
CaRMS match.

INTERNATIONAL MEDICAL SCHOOL DATA BY MEDICAL SCHOOL

CARIBBEAN

TABLE 14 CARIBBEAN MEDICAL SCHOOL DATA WEBSITE SOURCES

Location Medical School Website

Grenada St. George’s University http://www.sgu.edu/school-of-medicine/index.html
Dominica Ross University http://www.rossu.edu/medical-school/
Netherland Antilles SABA University School of Medicine www.saba.edu
Saint Kitts Windsor University http://windsor.edu
St. Maarten American University of the Caribbean School of Medicine www.aucmed.edu
Antigua American University of Antigua http://www.auamed.org/medical-school
Antigua University of Health Sciences Antigua www.uhsa.ag

Continued on page 32

CaRMS Report: 2010

31
 TABLE 14 CARIBBEAN MEDICAL SCHOOL DATA WEBSITE SOURCES

Aruba All Saints University of Medicine www.asumaruba.org

Aruba Xavier University School of Medicine http://edu.xusom.nl
Belize Central America Health Sciences University www.cahsu.edu
Cayman Islands St. Matthew’s University http://www.stmatthews.edu/school-of-medicine.shtml
Dominica All Saints University of Medicine www.allsaintsuniversity.org
Netherland Antilles Saint James School of Medicine www.sjsm.org
Netherland Antilles University of Sint Eustatius www.eustatiusmed.edu
Nevis Medical University of the Americas www.mua.edu/mua/
Saint Kitts International University of Health Sciences (IUHS) www.iuhs.edu
Saint Kitts University of Medicine and Health Sciences (UMHS) http://www.umhs-sk.org/
Saint Lucia Spartan Health Sciences www.spartanmed.org
Saint Lucia International American University www.iau.edu.lc
Trinidad and Tobago University of the West Indies www.uwi.edu

TABLE 15 NUMBER OF CSAS STUDYING MEDICINE IN THE CARIBBEAN

Location* Medical School Estimation of CSAs

Grenada St. George’s University ~ 660
Dominica Ross University ~ 270
Netherland Antilles SABA University School of Medicine ~ 320
Saint Kitts Windsor University ~ 200
St. Maarten American University of the Caribbean School of Medicine ~ 120
Antigua American University of Antigua Unknown**
Antigua University of Health Sciences Antigua Unknown**
Aruba All Saints University of Medicine Unknown**
Aruba Xavier University School of Medicine Unknown**
Belize Central America Health Sciences University Unknown**
Cayman Islands St. Matthew’s University Unknown**
Dominica All Saints University of Medicine Unknown**
Netherland Antilles Saint James School of Medicine Unknown**
Netherland Antilles University of Sint Eustatius Unknown**
Nevis Medical University of the Americas Unknown**
Saint Kitts International University of Health Sciences (IUHS) Unknown**
Saint Kitts University of Medicine and Health Sciences (UMHS) Unknown**
Saint Lucia Spartan Health Sciences Unknown**
Saint Lucia International American University Unknown**
Trinidad and Tobago University of the West Indies Unknown**
Estimated Total ~ 2000
* Only includes Caribbean medical schools known to have Canadian students.
** Unknown denotes locations where CSAs are known to study but no numbers were provided, an overall estimate was given for the region.

Overall, 20 schools in the Caribbean were identified as educating Canadian students. Although various other schools offer medical
education in the Caribbean, the CaRMS 2008 and 2009, as well as the MCC data only identified these schools as having current
Canadian graduates. This study was able to estimate that at least 2000 Canadians are studying medicine in the Caribbean.

CaRMS Report: 2010

32
 TABLE 16 GENERAL INFORMATION

Medical School Year University Founded Year International Program Began

St. George’s University 1977 1977
Ross University 1978 1978
SABA University School of Medicine 1993 1993
Windsor University 1998 1998
American University of the Caribbean School of Medicine 1978 1978
American University of Antigua 2004 2004
University of Health Sciences Antigua 1983 1983
Xavier University School of Medicine, Aruba 2004 2004
Xavier University School of Medicine, Bonaire 2003 2003
Central America Health Sciences University 1996 1996
St. Matthew’s University 1997 1997
All Saints University of Medicine, Aruba 2004 2004
All Saints University of Medicine, Dominica 2006 2006
Saint James School of Medicine, Bonaire 2000 2000
Saint James School of Medicine, Anguilla 2010 2010
University of Sint Eustatius 1999 1999
Medical University of the Americas 2001 2001
International University of Health Sciences (IUHS) 1998 1998
University of Medicine and Health Sciences (UMHS) 2008 2008
Spartan Health Sciences 1980 1980
International American University 2004 2004
University of the West Indies 1989 1989

Some of the oldest schools in the Caribbean, such as St. George’s and Ross, continue to educate the most Canadians in the midst of new
medical schools opening every year.

TABLE 17 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Available Admissions Admission Requirements

Fielded Through
St. George’s University Four year and BS/MD School - online MD (four year): bachelor’s degree, MCAT, specific coursework in:
dual degree application biology, inorganic chemistry, organic chemistry, math, English.

BS/MD Dual Degree: high school diploma, courses in mathematics,

science, biology or zoology, chemistry, English and one other
course, strong GPA in science, and SAT.

Ross University Four year School - online Cumulative GPA, GPA in pre-med coursework (inorganic chemistry,
application organic chemistry, biology, physics, math, English), MCAT, graduate
work and records, letters of recommendation, personal essay, work
history, professional or volunteer experiences, and personal interview.

Minimum three years of undergraduate studies or the equivalent

of 90 semester hours or 135 quarter hours—including premedical
requirements (biology, general/inorganic chemistry, biochem/
organic chemistry) from an accredited college or university. A
baccalaureate degree is recommended but not required. Prefer-
ence will be given to applicants who have completed a bachelor’s
degree or higher. All applicants who are US citizens, nationals or
permanent residents are required and all other students are
strongly encouraged to take the MCAT.

Continued on page 34

CaRMS Report: 2010

33
 TABLE 17 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Available Admissions Admission Requirements

Fielded Through
SABA University School Four year School - online Applicants are expected to have a minimum of 50 hours of direct
of Medicine application patient care experience to be eligible for admission to Saba
University School of Medicine. This experience can come from
volunteering in a hospital setting, shadowing physicians, working
as an EMT, etc.

Windsor University Four year and five School - form to Pre-med (five year) - applicants must be high school graduates
year be mailed to US with a minimum of 10 years of education from an American or
office internationally-recognized school.

MD (four year) - undergraduates or students enrolled in

undergraduate programs with one year of biology and chemistry
after high school.

Both four and five year programs consider: GPA, letters of

recommendation, personal essays, interview, and professional or
volunteer experiences.

American University of Four year School - online Baccalaureate degree from an accredited university to be obtained
the Caribbean School application as a condition of matriculation, MCAT, college credits must include
of Medicine the following: biology, general chemistry, organic chemistry, general
physics, and English.

A generous exposure to mathematics, humanities, and social

sciences is desired. Real life experience in the health care field is
strongly recommended. A personal interview may be requested at
the discretion of the Admissions Committee. AUC requires all
applicants to consent to a background check.

American University of Four year and School – online MD (four year) – at least 90 credits of college courses. Strongly
Antigua six year application recommends that applicants earn a degree from an accredited
undergraduate institution. Required courses: inorganic or general
chemistry, organic chemistry, biology or zoology, physics, English,
and calculus or statistics.

It is strongly advised that applicants complete advanced

science courses in biochemistry, anatomy/physiology, genetics,
microbiology, etc.

BHHS/MD (six year) - high school diploma with a minimum GPA of

3.0, and a combined score of 1100 on the SAT (verbal and math)
or a 24 on the ACT. Applicants must have completed at least three
years of science, English and mathematics courses.

Both four and six year programs require: letters of reference,

personal statement.

University of Health Four year School - form to At least 90 collegiate credit hours from accredited institutions.
Sciences Antigua be mailed to US The following courses are required: inorganic or general chemistry,
office organic chemistry, biology or zoology, physics, English, mathematics.
Letters of reference are also required.

Continued on page 35

CaRMS Report: 2010

34
 TABLE 17 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Available Admissions Admission Requirements

Fielded Through
All Saints University of Four year and five School – online MD (four year) - minimum of three years course work in an
Medicine, Aruba year application accredited college or university (minimum of 90 semester hours
or 135 quarter hours). Preference will be given to applicants
who have completed a baccalaureate degree or higher. Courses
must include: biology, chemistry, physics, mathematics, English,
and humanities.

MD (five year) – high school diploma.

Both four and five year programs require: personal essay, letters of
recommendation, MCAT score if available, TOEFL score if available.

Xavier University School Four year and five School - form to MD (four year) - at least two academic years and 90 credit hours of
of Medicine and a half year be mailed to US undergraduate studies including the following subjects: inorganic
office or general chemistry, organic chemistry, biology, physics, English,
and pre-calculus/calculus.

MD (five and a half years) - high school diploma, GPA 3.0, SAT
1200 (old system) 1800 (new system) or ACT 26.

Both four and five and a half year programs require: letters of
recommendation, structured questions and personal essay,
and interview.

Central America Health Four year School - form to An applicant must have satisfactorily completed no less than 90
Sciences University be mailed to US undergraduate semester hours (or equivalent number of quarter
office hours). Applicants are not required to have earned a bachelor's
degree, but an undergraduate degree from an American,
Canadian or internationally accredited college or university is
recommended. The following courses must have been completed
satisfactorily: biology, general chemistry, organic chemistry,
physics, math, English. Letters of recommendation and a personal
statement are required.

St. Matthew’s University Four year School – online Qualified candidates typically have earned an undergraduate
application degree from an approved college or university in the United
States, Canada or a recognized international institution. St.
Matthew's University will give consideration for admission to an
applicant who has earned 90 or more college semester credit
hours. Premedical studies should include the following courses:
inorganic (general) chemistry, organic chemistry, biology, language
arts, physics, English, humanities, and mathematics or computer
science. Letters of recommendation, personal statement, and
MCAT scores are required.

All Saints University of Four year and five School – online MD (four year) – minimum three years course work in an accredited
Medicine, Dominica year application college or university (minimum of 90 semester hours or 135 quarter
hours). Preference given to applicants who have completed a
baccalaureate degree or higher. Courses should include: biology or
zoology, general inorganic chemistry or advanced chemistry,
physics, mathematics, English, and humanities/social sciences.

MD (five year) – high school diploma.

Continued on page 36

CaRMS Report: 2010

35
 TABLE 17 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Available Admissions Admission Requirements

Fielded Through
Saint James School of Four year School – online Baccalaureate/bachelor's degree or a total of 90 credit hours
Medicine application (approximately three years of undergraduate education) at an
accredited college or university is required. Courses should
include: biology or zoology, general inorganic chemistry, advanced
chemistry, physics, English, humanities/social sciences.

University of Sint Four year School – online Bachelor's degree or 90 college credits. Required courses: biology,
Eustatius application inorganic chemistry, organic chemistry, physics, mathematics.

Medical University of Four Year School – online At least three years of undergraduate studies (the equivalent of
the Americas application 90 semester hours or 135 quarter hours from an accredited college
or university). Required courses: biology or zoology, inorganic
chemistry, organic chemistry, English.

MUA encourages students to complete courses in the arts, social

sciences, philosophy, literature and the humanities. Students
completing courses such as cell biology, anatomy and physiology,
genetics, biochemistry, molecular biology, physics, mathematics,
statistics and psychology/interpersonal skills and communication
are given preference in admissions.

International University Four year Unknown Bachelor’s degree in science or equivalent (90 to 120 semester
of Health Sciences or credit hours at the university/ college level). Courses should
(IUHS) include: physics, general chemistry, organic chemistry, biology,
mathematics/calculus. Additionally a biochemistry course is
recommended. Courses in microbiology, cellular physiology,
genetics, embryology while not required, are useful in providing
some of the essential skills and knowledge required for medical
education and assisting the Admissions Committee in assessing
a candidates readiness to study medicine.

Recommendations from professors and medical doctors, personal

interview, personal statement, MCAT scores, practical work
experience in the healthcare field.

University of Medicine Four year School – online A minimum of three years of study (90 semester credits) at an
and Health Sciences application accredited college or university however, a bachelor’s degree is
(UMHS) highly recommended. Courses in inorganic or general chemistry,
organic chemistry, general biology or zoology, physics, English,
and mathematics. Applicants should have a broad background in
the humanities and have completed at least 12–16 credit hours in
either the humanities and/or the social or behavioral sciences. It is
recommended that additional sciences courses such as genetics,
anatomy, physiology and biochemistry be taken.

Standardized tests including SATs, ACTs, MCATs, GREs, USMLE

Step I or any and all tests that will assist in evaluating application.

A personal essay, letters of recommendation, and a personal

interview are also required.

It is also highly recommended that applicants have experiences

in clinical settings, research, public health, or community
outreach activities.

Continued on page 37

CaRMS Report: 2010

36
 TABLE 17 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Available Admissions Admission Requirements

Fielded Through
Spartan Health Five year School – online Minimum requirement for admission is three years of college
Sciences application or university level studies (90 semester credit hours). A bac-
calaureate degree is preferred. Courses should include: biology,
physics, chemistry, organic chemistry or organic chemistry and
biochemistry sequence accepted, mathematics.

International American Four year School – online At least 90 credit hours of undergraduate coursework but
University application recommends the completion of a four year degree. Coursework
should include the following: inorganic or general chemistry,
organic chemistry, biology or zoology, physics, English, mathematics
(preferably calculus or statistics). Personal statement, two letters of
recommendation from academic or professional sources, and
resume listing extracurricular or medical voluntary activities.

University of the Five year School Applicants with first degrees from institutions other than the UWI
West Indies are eligible provided that the program of study has been accredited
by a relevant body or agency and is considered acceptable by the
UWI. Course credits have been obtained in biology/zoology and
chemistry. A minimum GPA of 3.0 or equivalent must be obtained,
as well as an autobiographical summary outlining reasons for career
choice, extracurricular activities outlined and original letters certified
from principals, supervisors or employers for each activity. The
university places emphasis on applicant’s voluntary participation
in community/social projects although consideration shall also
be given to other extracurricular activities, experiences and
abilities (such as music, sports, drama, and debating or proficiency
in a foreign language). Applicants may also be required to attend
an interview.

The majority of the schools in the Caribbean offer four year medical degrees with admissions based on some undergraduate courses taken in
the sciences and a certain GPA or a bachelor’s degree attained from an accredited university. MCAT scores are typically not required but
recommended by most schools. Applicants usually apply to Caribbean medical schools via an online application and can attend information
sessions provided by the medical schools in North America. Caribbean medical schools handle their own admissions with the aid of their
North American offices and do not make use of recruitment/admission agencies as other international medical education universities do.

CaRMS Report: 2010

37
 TABLE 18 CURRICULUM SUMMARY BY MEDICAL SCHOOL
Medical School Basic Science Curriculum
St. George’s University Two years: Anatomical Sciences, Behavioral
Sciences, Biochemistry and Genetics,
Bioethics, Clinical Skills, Microbiology,
Pathology, Pathophysiology, Pharmacology,
Physiology and Neuroscience, Public Health
and Preventive Medicine, and electives.
Ross University Two years: Developmental and Microscopic
Anatomy I/II, Biochemistry and Genetics I/II,
Doctor, Patient and Society I/II, Neuroscience,
Gross Anatomy I/II Medical Physiology I/II,
Microbiology and Immunology I/II, Pathology
I: General, Pathology II: Systemic and Clinical,
Medical Pharmacology I/II, Introduction to
Clinical Medicine, and Behavioral Sciences.
SABA University School Two years: Cellular Biology, Embryology,
of Medicine Histology, Gross Anatomy with human
cadavers, Biochemistry and Medical Genetics,
Physiology, Epdiemiology, Microbiology,
Neuroscience and Medical Psychology, Medical
and Legal Ethics, Pathology, Pharmacology,
Physical Diagnosis, and Clinical Pathology.
Windsor University Two years: Physiology, Biochemistry, Microbi-
ology, Pharmacology, Anatomy, and Pathology.
American University of Two years: Anatomy/Embryology, Molecular
the Caribbean School and Cell Biology I/II, Histology, Physiology I/II,
of Medicine Immunology and Infection, Biostatistics,
Introduction to Clinical Med/Clerkships
1/2/3/4/5/6, Pathology I/II, Medical
Microbiology, Neuroscience, Pharmacology
I/II, and Behavioral Science I/II.
American University of Two years: Gross Anatomy/Embryology,
Antigua Histology/Cell Biology, Doctor, Patients, and
Society, Neuroscience, Medical Physiology,
Biochemistry, Genetics, Behavioral Science,
Microbiology, Immunology, General
Pathology, Pharmacology, Systemic
Pathology, Introduction to Clinical Medicine,
and Preliminary Clinical Training.
38
Clinical Curriculum
Two years (80 weeks): Core clerkship year – Medicine,
Surgery, Pediatrics, Obstetrics/Gynecology, and Psychiatry.
Senior year - Medicine Sub-Internship, Primary Care (Family
Practice, Emergency Medicine, Outpatient Experience in
General Medicine, General Pediatrics, or General Obstetrics/
Gynecology), Medicine elective, Pediatric elective or
Sub-Internship, and additional electives.
Two years (90 weeks): Advanced Introduction to Clinical Med-
icine, Medicine, Obstetrics/Gynecology, Pediatrics, Psychiatry,
Surgery, Family Medicine, electives and research electives.
Two years (72 weeks): core rotations - Surgery, Internal Medicine,
Pediatrics, Psychiatry, and Obstetrics and Gynecology.
Elective clinical rotations - student may select based upon
their projected medical specialty.
Two years (72 weeks): Internal Medicine, Surgery, Obstetrics,
Gynecology, Pediatrics, Psychiatry, and elective rotations.
Two years (72 weeks): Internal Medicine, Surgery, Pediatrics,
Obstetrics and Gynecology, Psychiatry, and 30 weeks in
clinical elective rotations.
Two years (72 weeks): Family Practice I/Internal Medicine I,
Internal Medicine, Surgery, Pediatrics, Obstetrics and
Gynecology, Psychiatry, and Family Medicine.
Electives - Anesthesiology, Immunology, Cardiology, Critical
Care, Dermatology, Emergency Medicine, Endocrinology,
Diabetes and Metabolism, Gastroenterology, Geriatric
Medicine, Infectious Diseases, Nephrology, Neurology,
Oncology, Ophthalmology, Preventive Medicine, Pul-
monary Disease, Radiology, Rheumatology, Orthopedic
Surgery, and Pathology.
Continued on page 39
CaRMS Report: 2010
 TABLE 18 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

University of Health Two years: basic sciences and USMLE prep. Two years (78 weeks): Internal Medicine, General Surgery,
Sciences Antigua Obstetrics and Gynecology, Psychiatry, and Family Medicine.

Examples of electives: Family Practice, Cardiology,

Emergency Medicine, Anesthesiology, Orthopedic Surgery,
Otolaryngocology, Neurology, Radiology, Preventative
Medicine/Infectious Disease, electives in General Surgery.

All Saints University of Two years: Gross Anatomy, Histology, Medical Two Years (72 - 80 weeks): Internal Medicine, General Surgery,
Medicine Embryology, Medical Ethics, Biochemistry, Obstetrics and Gynecology, Pediatrics, Psychiatry, Family
Physiology, Genetics, Neurosciences, Microbiol- Practice, and electives (student’s choice).
ogy and Immunology, Psychology, Pathology I,
Pharmacology, Pathology II, Epidemiology and
Preventive Medicine, Physical Diagnosis, and
Introduction to Clinical Medicine.

Xavier University School Two years: Gross and Development Anatomy, Two years (72 weeks): Family Medicine, Pediatrics, Obstetrics
of Medicine Histology and Cell Biology, Epidemiology and Gynecology, Behavioural Medicine, Internal Medicine,
and Preventative Medicine, Introduction to Surgery, and electives (student’s choice).
Info Medicine, Physiology 1, Gross and
Development Anatomy II, Biochemistry and
Molecular Medicine, Physiology II,
Neuroscience, Pathology I, Microbiology/
Immunology, Medical Psychology and Ethics,
Pathology II, Pharmacology, Physical
Diagnosis, Introduction to Clinical Medicine,
and Getting into Residencies.

Central America Health Two years: Gross Anatomy, Medical Physiology,
Sciences University Histology, Embryology, Biostatistics,
Biochemistry, Microbiology, Neuroanatomy,
Human Genetics, Immunology & Allergy,
Behavioral Sciences, Epidemiology & Public
Health, Nutrition, Pharmacology, General
Pathology, ENT, Respiratory Medicine, Neurol-
ogy, Fluid/Electrolytes & Renal, Endocrinology,
Dermatology, Legal Medicine & Medical Ethics,
Tropical Medicine & Parasitology, Psychiatry,
Anesthesiology, Gastroenterology, Hematol-
ogym, Oncology, Orthopedics, Principles of
Clinical Medicine, Radiology, Ophthalmology,
Surgery & Orthopedic Surgery, Obstetrics &
Gynecology, Pediatrics, Systematic Pathology,
Geriatric Medicine, Child Abuse & Human
Sexuality, Infectious Diseases, Molecular
Biology, Cardiology, Physical Diagnosis, Forensic
Medicine, Urology, and Rheumatology.
Two years (56 weeks + electives): Internal Medicine, Obstetrics
& Gynecology, General Surgery, Pediatrics, Primary Care,
Family Medicine & Preventive Medicine, and Psychiatry.
Electives: Anesthesiology, Dermatology, Family Medicine,
Internal Medicine, Neurosurgery, Occupational Medicine,
Orthopedic Surgery, Pathology, Pediatric Surgery, Physical
Diagnosis/ Rehabilitation, Radiology (including radiation
safety), Thoracic Surgery, Clinical Pathology, Emergency
Medicine, Gynecology, Neurology, Obstetrics,
Ophthalmology, Otorhinolaryngology, Pediatrics, Plastic
Surgery, Preventive Medicine, Surgery, Urology, Cardiology,
and Gastroenterology.

Continued on page 40

CaRMS Report: 2010

39
 TABLE 18 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

St. Matthew’s University Two years: Patient-Doctor Relations, Principles
of Research and Evidence Based Medicine,
Histology and Cell Biology, Developmental
and Gross Anatomy, Patient-Doctor Relations
II, Neuroscience, Biochemistry and Genetics,
Physiology, Medical Spanish, Patient-Doctor
Relations III, Medical Microbiology I, Medical
Pharmacology I, Biostatistics and Epidemiol-
ogy, Behavioral Sciences, Pathology I, Patient-
Doctor Relations IV, Medical Microbiology II,
Medical Pharmacology II, Pathology II, Clinical
Therapeutics, Introduction to Clinical Medi-
cine, and Fundamentals of Clinical Sciences.
Two years (76 weeks): Internal Medicine, Surgery, Pediatrics,
Obstetrics & Gynecology, Family Practice, and Psychiatry.
Electives: Allergy and Immunology, Anesthesiology,
Cardiology, Oncology, Critical Care, Dermatology, Pathology,
Endocrinology, Preventive Medicine, Emergency Medicine,
Pulmonary Disease, Family Practice, Radiology, Gastroenterol-
ogy, Rheumatology, Gerontology, Ophthalmology, Neurology,
Nephrology, Urology, Hematology, Infectious Disease, and
Community Health Care.
An elective in Neurology is required.

Saint James School of Two years: Histology, Gross Anatomy and
Medicine Embryology, Medical & Legal Ethics, Physiol-
ogy, Biochemistry, Neuroscience, Genetics,
Research in Health and Medicine, Pathology I,
Microbiology, Pharmacology, Medical Psychol-
ogy, Research and Health and Medicine II,
Pathology II, Epidemiology and Biostatistics,
Physical Diagnosis & Clinical Medicine, and
Research in Health and Medicine III.
Two years (96 weeks): Medicine, Surgery, Obstetrics &
Gynecology, Family Practice, and Psychiatry.
Electives: Allergy and Immunology Neurology, Cardiology
Occupational Medicine, Critical Care Medicine Oncology,
Dermatology Ophthalmology, Emergency Medicine Orthope-
dics, Endocrinology Psychiatry, Family Practice Pulmonology,
Gastroenterology Radiology, General Medicine Rehabilitation
Medicine, Hematology Rheumatology, Infectious Diseases
Surgical subspecialties, and Nephrology Urology.

Note: This is a partial list of possible elective rotations.

University of Sint Two years: Professionalism & Patient-Doctor Two years (72 weeks): Internal Medicine, Surgery,
Eustatius Skills I, Histology and Cell Biology, Public Obstetrics & Gynecology, Family Practice, Psychiatry,
Health, Gross & Developmental Anatomy, Pediatrics, and electives.
Ethics & Patient-Doctor Skills II, Neuroscience,
Biochemistry / Genetics, Physiology, Commu-
nication & Patient-Doctor Skills III, Medical
Microbiology, Medical Psychology, Pathology
I, Physical Diagnosis & Patient-Doctor Skills IV,
Medical Pharmacology, Pathology II, Introduc-
tion to Clinical Medicine, and Fundamentals
of Clinical Medicine.

Medical University of Two years: Gross Anatomy, Histology Two years (72 weeks): Surgery, Internal Medicine, Pediatrics,
the Americas and Cell Biology, Informatics and Psychiatry, and Obstetrics & Gynecology, and electives.
Evidence-Based Medicine, Informatics and
Evidence-Based Medicine, Biochemistry,
Human Physiology, Medical Psychology,
Medical & Legal Ethics, Microbiology and
Immunology, Neurosciences, Medical
Genetics, Epidemiology and Preventive
Medicine, Pharmacology, Pathology I,
Physical Diagnosis, Clinical Pathology II,
Medical Board Review, and Introduction to
Clinical Medicine.

Continued on page 41

CaRMS Report: 2010

40
 TABLE 18 CURRICULUM SUMMARY BY MEDICAL SCHOOL
Medical School Basic Science Curriculum
International University Two years: Introduction to Basic Medical
of Health Sciences Science, Respiratory and Cardiovascular
(IUHS) Systems, Endocrine & Reproductive Systems,
Gastrointestinal and Renal Systems, Central
and Peripheral Nervous Systems and General
Principles of Psychiatry, Hematology, Muscular
system, Dermatology, and the Febrile
Exanthem, Musculoskeletal System and Eye,
Ear, Nose and Throat, Major Infectious
Diseases, Autoimmune Diseases including
Vasculitis, and Congenital Anomalies, Review
and Examination Preparation, and Introduction
to Clinical Medicine.
University of Medicine Two years: Anatomy, Histology, Cell and
and Health Sciences Molecular Biology, Physiology, Biochemistry,
(UMHS) Genetics, Embryology, Pathology, Neuro-
science/Neuroanatomy, Immunology and
Microbiology, Behavioural Science, Pharma-
cology and Therapeutics, Biostatistics and
Epidemiology, Introduction to Clinical
Medicine, and Medical Ethics.
Spartan Health Two years: Gross Anatomy, Medical Physiol-
Sciences ogy, Histology, Embryology, Biostatistics &
Medical Writing, Biochemistry, Microbiology,
Neuroanatomy, Human Genetics, Immunology
& Allergy, Behavioral Science, Epidemiology
and Public Health, Nutrition, Pharmacology,
General Pathology, Legal Medicine and Med-
ical Ethics, Tropical Medicine and Parasitology,
and Systemic Pathology.
Pre-clinical: Infectious Diseases, Introduction
to Medicine, Otorhinolaryngology, Respira-
tion, Neurology, Cardiology, Fluids/Elec-
trolytes & Renal, Dermatology, Endocrinology,
Psychiatry, Anesthesiology, Introduction to
Medicine II, Gastroenterology, Hematology,
Oncology, Orthopedics, Principles of Clinical
Medicine, Radiology, Physical Diagnosis, Oph-
thalmology, Surgery & Orthopedic Surgery,
Obstetrics & Gynecology, Pediatrics, Geriatric
Medicine & Pain Management, Child/Spousal
Abuse and Human Sexuality.
CaRMS Report: 2010
Clinical Curriculum
Two years (80 weeks): Internal Medicine, Surgery, Obstetrics
& Gynecology, General Practice, Psychiatry, and Pediatrics.
Electives: Allergy and Immunology, Anesthesiology,
Cardiology, Colon and Rectal Surgery, Critical Care
Medicine, Dermatology, Emergency Medicine,
Endocrinology and Metabolism, Epidemiology, Family
Medicine, Gastroenterology, Geriatric Medicine,
Hematology, Infectious Disease, Neonatal Medicine,
Nephrology, Neurology, Nuclear Medicine, Oncology,
Ophthalmology, Orthopedics, Otolaryngology, Pathology,
Pediatric Surgery, Physical Medicine & Rehabilitation,
Plastic Surgery, Preventive Medicine, Pulmonology,
Radiology, Respirology, Rheumatology, Sports Medicine,
Thoracic Surgery, Urology, Vascular Surgery.
Two years: Introduction to Clinical Medicine II, Biological
Basis of Clinical Medicine, Internal Medicine, Surgery,
Pediatrics, Obstetrics and Gynecology, Psychiatry, Family
Practice, and electives.
Two years (80 weeks): Internal Medicine, General Surgery,
Surgical Sub-specialty, Obstetrics & Gynecology, Family
Medicine, Psychiatry, Pediatrics, Radiology, and Clinical
Pathology.
Must include a minimum of three (3) or a maximum of five
(5) from the following surgical electives: Anesthesiology,
Geriatric Medicine, Neurosurgery, Ophthalmology,
Otorhinolaryngology, Orthopedic Surgery, Pediatric Surgery,
Plastic Surgery, Thoracic Surgery, Vascular Surgery, Urology,
and Emergency Medicine including Trauma.
Electives: Anesthesiology, Geriatric Medicine, Orthopedic,
Surgery, Dermatology, Pathology, Emergency Medicine,
Pediatrics, Family Medicine, Forensic Medicine, Gynecology,
Internal Medicine, Neurology, Radiology, Obstetrics,
Ophthalmology, Otorhinolaryngology, Occupational
Medicine, Surgery, and Physical and Rehabilitation Medicine.
Continued on page 42
41
 TABLE 18 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

International American Two years: Biochemistry, Genetics & Nutrition, Two years (76 weeks): Internal Medicine, General Surgery,
University Microscopic Anatomy - Histology, Embryology, Obstetrics & Gynecology, Family Practice, Psychiatry,
Cell Biology, Doctor - Patient - Society - Medical Pediatrics, and electives.
Ethics, Medical Law, Epidemiology, Biostatiscs,
Gross Anatomy - Anatomy and Neuroanatomy,
Physiology, Pathology - I - General Pathology,
Microbiology & Immunology, Parasitology,
Virology, Doctoring I - Behavioural Science,
Geriatrics, Public Health and Preventive
Medicine, Pathology - II - Systemic Pathology,
Pharmacology & Therapeutics, Doctoring
II - Physical Diagnosis and Clinical Medicine,
and Introduction to Clinical Medicine.

University of the West Two years: example of courses - Anatomy, Core clerkships: Medicine, Surgery, Pediatrics, Obstetrics &
Indies Physiology, Biochemistry, Pathology, Gynecology, and Psychiatry and Public Health.
Pharmacology, and Community Health.

Typically, Caribbean medical schools base their curriculum off of the North American standard. Most offer two years of basic sciences at their
campus in the Caribbean, and courses usually include, but are not limited to: Anatomy, Physiology, Pathology, Pharmacology, and Ethics. The
basic sciences are then followed by two years of clinical clerkships which are taken in varying locations across the United States and Canada.
Typical core clerkships include: Medicine, Surgery, Pediatrics, OB/GYN, Psychiatry, and General Practice.

TABLE 19 ACCREDITATION BY MEDICAL SCHOOL

Medical School Accreditation and Approvals (Domestic and International)

St. George’s University Caribbean Accreditation Authority for Education in Medicine and Other Health
Professions (CAAM). HP, accredited by the Government of Grenada, approved by
the New York State Education Department, recognized by the Medical Board of
California, approved by the Florida Commission on Independent Education of the
Florida Department of Education, the National Committee on Foreign Medical
Education and Accreditation, the Bahamas Medical Council, the Bermuda Medical
Council, DIKATSA (Greek Medical Licensing Authority), the Sri Lankan Medical
Council, the Thailand Medical Council, the Government of Botswana, the Government
of St. Vincent, the Medical Board of Trinidad and Tobago, the Association of
Caribbean Tertiary Institutions, Inc.

Ross University Caribbean Accreditation Authority for Education in Medicine and Other Health
Professions (CAAM), HP, Commonwealth of Dominica, the United States Department
of Education through the National Committee on Foreign Medical Education and
Accreditation (NCFMEA), the state of New York, the state of California, the state of
New Jersey, the state of Florida, the General Medical Council of Great Britain.

SABA University School of Medicine
Accreditation Commission on Colleges of Medicine (ACCM), the United States
Department of Education, the NVAO, the Accreditation Organization of the
Netherlands and Flanders, approved by the New York State Education Department,
recognized by the Division of Licensing of the Medical Board of California, licensed
by the Commission for Independent Education, the Florida Department of Education,
approved by the Kansas State Board of Healing Arts.

Continued on page 43

CaRMS Report: 2010

42
 TABLE 19 ACCREDITATION BY MEDICAL SCHOOL

Medical School Accreditation and Approvals (Domestic and International)

Windsor University Medical Council and Board of Government of St. Kitts, the Educational Commission
for Foreign Medical Students (ECFMG), the United States Medical Licensing Boards
for taking board exams in basic and clinical sciences.

American University of the Caribbean Accreditation Commission on Colleges of Medicine (ACCM), the United States
School of Medicine Department of Education, the Medical Board of California, the Texas Medical Board,
the New York State Board of Medicine, the Florida Department of Education's
Commission for Independent Education.

American University of Antigua New York State accreditation

University of Health Sciences Antigua Ministry of Education of the Government of Antigua and Barbuda

All Saints University of Medicine Chartered and recognized by the government of Aruba

Xavier University School of Medicine Unknown

Central America Health Sciences University Chartered by the Government of Belize

St. Matthew’s University Accreditation Commission on Colleges of Medicine (ACCM)

All Saints University of Medicine Government of the Commonwealth of Dominica

Saint James School of Medicine Federal Government of the Netherlands.

University of Sint Eustatius Unknown

Medical University of the Americas Department of Education of St. Christopher-Nevis

International University of Health Sciences The Government of St. Christopher and Nevis in the West Indies
(IUHS)

University of Medicine and Health Sciences The Government of St. Christopher and Nevis in the West Indies
(UMHS)

Spartan Health Sciences The Government of St. Lucia

International American University Chartered and authorized by the Government of St Lucia, recognized by the
Educational Commission for Foreign Medical Graduates (ECFMG), and
recommended for approval with the New York State Education Department.

University of the West Indies Unknown

Caribbean medical school accreditation is wide and varied. Because schools reside in different Caribbean countries, the accreditation
is diverse. Most medical schools are accredited by the government, while some have also attained approvals from departments of
education and specific states in the US.

CaRMS Report: 2010

43
 TABLE 20 TUITION BY MEDICAL SCHOOL
Medical School Total Basic Sciences Total Clinical Years Total Tuition Average Yearly
Tuition ($CAD) Tuition ($CAD) ($CAD) Tuition($CAD)
St. George’s University $133,532 $115,397 $248,929 $62,232
Ross University $69,326 $113,378 $182,705 $45,676
SABA University School of Medicine Not available Not available $108, 714 $27,178
Windsor University Not available Not available $52,938 $13,234*
American University of the Caribbean School of Medicine $84,870 $84,499 $169,369 $42,342
American University of Antigua $45,117 $76,982 $122,099 $30,525*
University of Health Sciences Antigua Not available Not available $121,565 $30,391
All Saints University of Medicine, Aruba Not available Not available $71,021 $17,755*
Xavier University School of Medicine $35,752 $49,013 $84,764 $21,191*
Central America Health Sciences University $25,673 $38,192 $63,865 $15,966
St. Matthew’s University $47,209 $52,779 $99,988 $24,997
All Saints University of Medicine, Dominica $31,800 $47,708 $79,508 $19,877*
Saint James School of Medicine $23,339 $48,482 $71,822 $17,955
University of Sint Eustatius $41,374 $53,468 $94,843 $23,711
Medical University of the Americas Not available Not available $103,409 $25,852
International University of Health Sciences (IUHS) Not available Not available Not available Not available
University of Medicine and Health Sciences (UMHS) $38,213 $75,219 $113,432 $28,358
Spartan Health Sciences $26,257 $18,831 $45,087 $9,017
International American University $35,009 $50,392 $85,401 $21,350

* School has more than one program. Average yearly tuition was calculated using four years.
Attaining a medical degree in the Caribbean is quite costly. Many schools where Canadians are found studying average between $20,000
(CAD) and $60,000 (CAD) per year. While a few schools do report lower tuition costs, this is not typical.

TABLE 21 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

St. George’s US, UK, Canada US: New York, New Jersey, Michigan, Connecticut, Maryland,
University California, Florida.
Canada: Vancouver

Ross University Bahamas, Commonwealth US: California, Connecticut, Washington DC, Florida, Illinois, Louisiana,
of Dominica, US, Puerto Rico Maryland, Massachusetts, Michigan, New Jersey, New York, Utah, Virginia,
Washington, Wisconsin.

SABA University US, Canada US: Connecticut, New York, Illinois, Massachusetts, Maryland,
School of Medicine Louisiana, Georgia.

Windsor University US US: Chicago, Tennessee, Georgia, New Hampshire, Virginia, New York,
Ohio, Connecticut, West Virginia.

Continued on page 45

CaRMS Report: 2010

44

Medical School
American University
of the Caribbean School
of Medicine
American University of Antigua
University of Health
Sciences Antigua
All Saints University of
Medicine, Aruba and
Dominica
Xavier University School
of Medicine
Central America Health
Sciences University
St. Matthew’s University
Saint James School of Medicine
University of Sint Eustatius
Medical University of the
Americas
International University of
Health Sciences (IUHS)
University of Medicine and
Health Sciences (UMHS)
Spartan Health Sciences
International American
University
University of the West Indies
Caribbean medical schools generally do not offer clerkship rotations within the Caribbean. Most clerkships are outsourced to the United
States, Canada and occasionally the United Kingdom.
CaRMS Report: 2010
TABLE 21 CLERKSHIPS BY MEDICAL SCHOOL
Clerkship Locations
US, UK
US, Puerto Rico
US, Canada, Puerto Rico
US, Cuba, Mexico, India,
or Canada. Clerkships are
predominately in the US
US, Puerto Rico
Unknown
US, UK
US and Caribbean
Clinical sites in over
30 states in the US
US and Canada
US, Canada, Mexico,
Australia, India
US, and Puerto Rico
US
Locations in Europe, Asia,
and North America.
Unknown
Clinical and Affiliated Hospital Locations
US: Ohio, Louisiana, New York, Connecticut, California, Florida,
Illinois, Maryland, Michigan.
US: Connecticut, Washington D.C., Illinois, Los Angeles, Maryland,
Michigan, New York, Ohio.
Puerto Rico: San Juan
US: Alabama, Georgia, Maryland, Montana, Los Angeles, California,
Texas, Michigan, Pennsylvania, Indiana, West Virginia, Florida, Ohio,
Virginia, Tennessee, Illinois, North Carolina, Wyoming, New Mexico,
Connecticut, Kansas, New York, Colorado, Minnesota, Missouri,
Arizona, Massachusetts.
Canada: Niagara Falls region.
Puerto Rico: Guayama, Bayamon, San Juan, Humacao.
Unknown
US: Georgia, Illinois, Los Angeles, Virginia, New York, Washington,
Maryland.
Puerto Rico: San Juan
Unknown
US: Colorado, Florida, Georgia, Illinois, Maryland, Massachusetts,
Michigan, New York, North Carolina, Ohio, Virginia.
UK: London, Barnsley, Stockport, Middlesex, Kent.
Unknown
Sample of US locations: Maryland, Colorado, Virginia, Arizona, Illinois,
Los Angeles, North Carolina, Ohio.
US: Los Angeles, Virginia, Georgia, Maryland, Illinois, New York,
Utah, Connecticut.
India: Andhra Pradesh, Mumbai.
US: New York, Connecticut, Illinois, Georgia, Maryland, Michigan.
Puerto Rico
Unknown
US: Los Angeles, Illinois, Maryland, Colorado, Georgia.
Unknown
45
 AUSTRALIA

TABLE 22 AUSTRALIAN MEDICAL SCHOOL DATA WEBSITE SOURCES

Location Medical School Website

Australia University of New South Wales http://www.med.unsw.edu.au/
Australia Australian National University http://cmbe.anu.edu.au/
Australia Monash University http://www.med.monash.edu.au/schools.html
Australia University of Adelaide http://health.adelaide.edu.au/school_medicine/
Australia University of Notre Dame www.nd.edu.au
Australia University of Western Sydney www.uws.edu.au
Australia University of Western Australia http://www.meddent.uwa.edu.au/
Australia University of Tasmania http://www.medicine.utas.edu.au/
Australia University of Queensland http://www.uq.edu.au/study/program.html?acad_prog=2046
Australia University of Melbourne http://www.mdhs.unimelb.edu.au/
Australia Flinders University of South Australia http://www.flinders.edu.au/medicine/
Australia University of Sydney http://sydney.edu.au/medicine/
Australia Bond University http://www.bond.edu.au/faculties-colleges/faculty-of-health-sciences-and-medicine/index.htm
Australia University of Wollongong http://www.uow.edu.au/gsm/index.html
Australia Deakin University http://www.deakin.edu.au/hmnbs/medicine/
Australia James Cook University http://www-public.jcu.edu.au/courses/health/medicine/index.htm
Australia University of Newcastle http://www.newcastle.edu.au/school/medicine-public-health/

TABLE 23 NUMBER OF CSAS STUDYING MEDICINE IN AUSTRALIA TABLE 24 GENERAL INFORMATION

Location Medical School Number of Medical School Year Year

CSAs Estimated University International
Australia University of New South Wales < 10 Founded Program Began
Australia Australian National University < 10
University of New South Wales 1949 1951
Australia Monash University < 10 Australian National University 1946 unknown
Australia University of Adelaide < 10 Monash University 1958 unknown
Australia University of Notre Dame Unknown* University of Adelaide 1874 unknown
Australia University of Western Sydney Unknown* University of Notre Dame 1989 unknown
University of Western Sydney 1989 unknown
Australia University of Western Australia < 10
University of Western Australia 1911 unknown
Australia University of Tasmania < 10
University of Tasmania 1890 unknown
Australia University of Queensland ~ 230 University of Queensland 1909 unknown
Australia University of Melbourne ~ 20 University of Melbourne 1853 unknown
Australia Flinders University of South Australia ~ 70 Flinders University of South Australia 1966 unknown
Australia University of Sydney ~ 140 University of Sydney 1850 unknown
Bond University 1987 unknown
Australia Bond University < 10
University of Wollongong 1951 2007
Australia University of Wollongong < 10 Deakin University 1974 unknown
Australia Deakin University Unknown* James Cook University 1970 unknown
Australia James Cook University < 10 University of Newcastle 1965 1951
Australia University of Newcastle Unknown*
Australian medical schools currently educating Canadians
Estimated Total ~ 550 were typically founded long before the boom of international
medical education.
* Unknown denotes locations where CSAs are known to study but no numbers were
provided. An overall estimate was given for the region.

Overall, 17 medical schools were identified in Australia educating an

estimated 550 Canadian students.

CaRMS Report: 2010

46
 TABLE 25 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Admissions Fielded Admission Requirements

Available Through
University of New Six year MBBS School - online As a minimum, undergraduate applicants will need to have a
South Wales application qualification considered to be equivalent to year 12 (completion
of high school) in Australia. OSSD score of 92, International
Baccalaureate of 36 to eligible for consideration/38 minimum
for interview.

Applicants with university results: applicants that have completed

one year or more of tertiary studies at undergraduate level by
the end of 2010 will be assessed on the basis of both their high
school results and their tertiary results. These will be combined
in the ratio of 50:50. They will be required to attain an academic
rank of at least 97 to be eligible for consideration to UNSW
Medicine. Please note that there is no separate quota for
university students.

Required: UMAT and interview.

Australian National Four year School – mail in Bachelor’s degree in any discipline, GPA, Graduate Australian
University MBBS application or Australian Medical Schools Admission Test (GAMSAT) or Medical College
Council for Educational Admissions Test (MCAT). A minimum overall result of 55 is
Research (ACER) required for GAMSAT, with no less than 50 for each section or
alternatively for MCAT, a minimum of 8/8/M/8, and interview.

Monash University Four year Victorian Tertiary Four year MBBS: completed three-year undergraduate degree or
MBBS and Admissions Centre, equivalent qualification (degree does not have to be medically or
Five year Oztrekk, or school – scientifically oriented), GAMSAT or MCAT scores, and interview.
MBBS online application.
Six year MBBS: equivalent Australian Year 12. International
Baccalaureate subject prerequisites: a score of at least 5 in Eng-
lish SL or 4 in English HL or 6 in English B SL or 5 in English B HL,
and a score of at least 5 in chemistry SL or 4 in chemistry HL.

Both four year and six year require: gaining the required result in
one of the following tests of English language: IELTS score of 7.0
with no individual band score less than 6.5. TOEFL minimum test
score of either; in the written TOEFL, 600 with a Test of Written
English (TWE) score of at least 5.0; or in the Internet-based TOEFL,
an overall score of at least 100 with at least 24 in the written
section and no less than 20 in any other section. International
Student Admissions Test (ISAT).

University of Adelaide Six year School - application to Provincial high school diploma (i.e. OSSD formerly known as
be mailed to university Canadian Grade 13), International TER score of 90, and IELTS
or Australearn Total 6.5.

University of Notre Four year ACER GAMSAT, GPA minimum of 5.0 over three years of study,
Dame bachelor’s degree, interview, and personal statement.

Continued on page 48

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47
 TABLE 25 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Admissions Fielded Admission Requirements

Available Through
University of Five year UAC International Ontario Secondary School Diploma (Canada OSSD) - score
Western Sydney based on Secondary School Diploma including six University
Preparation Courses with minimum 65% average. Achieve a
scholastic performance in the final year of secondary school
equivalent to a New South Wales University Admission Index of
95 (International Baccalaureate 34) or higher.

For those who have completed a three year or longer bachelor’s

degree, the GPA in the degree must be at least 5.5 on the 7
point scale.

Have completed IELTS or equivalent examination (Academic

Module) and achieve a minimum score of 6.5 in each of the four
components, and an overall score of at least 7.0.

University of Six year School - form to be mailed to Minimum International Baccalaureate of 37, and ISAT.
Western Australia university, or UWA overseas
representative

University of Five year School - forms to be mailed Chemistry at Australian year 12 level or equivalent, mathematics
Tasmania to university at Australian year 12 level or equivalent, Ontario Secondary
School Diploma – average 89, and ISAT score.

University of Four year School - forms to be mailed Minimum bachelor’s degree, minimum GPA 0f 5.0 out 7.0 scale
Queensland to university or 2.8 out of 4 scale, and GAMSAT or MCAT, UMAT, ISAT.

University of Four year GMAC Online Admission System Bachelor's degree, second year university courses in anatomy,
Melbourne or direct to International Admissions physiology, and biochemistry, GAMSAT or MCAT, GPA, and
at the University of Melbourne. interview.

Flinders University Four year School – online application Bachelor's degree, and GAMSAT or MCAT.
of South Australia

University of Four year Australian Council for Educational Bachelor's degree, GAMSAT, and interview.
Sydney Research (ACER) or Australearn

Bond University Five year School – online application GPA 5.0 out of 7 scale or 2.8 out of 4 scale, and GAMSAT or MCAT.

University of Four year Australearn Bachelor’s degree, GPA 5.0/7 or 2.8/4, GAMSAT or MCAT,
Wollongong portfolio, and interview.

Deakin University Four year School – online application IELTS score of 7.0 or undergraduate degree in English, MCAT
8/8/M/8 or GAMSAT score of 50, bachelor’s degree, and GPA 5.0/7.

James Cook Six year QTAC A minimum score of 63% or better in the Ontario Secondary School
University Diploma based on the average of the best six OSSD or OAC
subjects. Courses in mathematics and chemistry.

University of Five year Directly to school Year 12 studies or higher education qualifications or overseas qualifica-
Newcastle tions considered equivalent to Australian qualifications, and UMAT.

Medical programs in Australia are varied and range from four to six years. Four year degrees generally require a bachelor’s degree,
MCAT or GAMSAT and a certain GPA. Five and six year degrees are typically aimed at high school graduates and require a certain
overall average for admission.
CaRMS Report: 2010
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 TABLE 26 CURRICULUM SUMMARY BY MEDICAL SCHOOL
Medical School Basic Science Curriculum
University of New Two years: MFAC1501 Foundations, MFAC1520
South Wales Society & Health, MFAC1521 Beginnings, Growth &
Devl. A, MFAC1522 Beginnings, Growth & Devl. B,
MFAC1523 Health Maintenance A, MFAC1524
Health Maintenance B, MFAC1525 Ageing & End-
ings A, MFAC1526 Ageing & Endings B, MFAC1527
Society & Health, MFAC1511 Phase 1 Portfolio Ex-
amination, MFAC1512 Phase 1 End-of-Phase Written
Examination, MFAC1513 Phase 1 Clinical and
Communications Skills Examination, MFAC2501
Society and Health 3, MFAC2502 Beginnings,
Growth and Devl 3, MFAC2503 Health Maintenance
3, MFAC2504 Ageing and Endings 3, MFAC2511
Phase 2 Portfolio Examination, MFAC2512 Phase 2
Integrated Clinical Examination, MFAC4501
Independent Learning Project 1, MFAC4502
Independent Learning Project 2, and MFAC4503
Independent Learning Project 3.
Australian Two years: DNA to Death, Cardiorespiratory,
National Renal, Endocrine & Reproductive Health,
University Cardiorespiratory, Renal, Endocrine & Reproductive
Health, Musculoskeletal, Neurosciences, Human
Disease & Society, Research Project.
Monash Four year MBBS (two years): basic medical and
University behavioural sciences (Anatomy, Biochemistry,
Genetics, Immunology, Microbiology, Pathology,
Pharmacology, Physiology, Psychology and
Sociology). In second year, the students will study
integrated medicine and surgery, which will be
taught together with a series of problem based
and case-based learning sessions.
Five year MBBS (two years): the first two years,
blocks of systems-based sub-units will be presented
with a mix of basic medical science content, patient-
based presentations and discussions in small
groups. These sub-units are set in appropriate
clinical contexts, largely through the use of patient-
oriented learning. Topics include: Cardiovascular,
Endocrinology, Gastrointestinal, Genomics, Human
Behaviour, Human Development and Growth, Im-
munology and Infection, Metabolism, Molecules,
Cells and Tissues, Musculoskeletal, Neurosciences,
Nutrition, Renal, Reproduction, and Respiratory.
University of Three years: Scientific Basis of Medicine.
Adelaide
CaRMS Report: 2010
Clinical Curriculum
Two years (52 weeks): MFAC3501 Medicine, MFAC3502
Surgery, MFAC3503 Psychiatry, MFAC3504 Primary Care,
MFAC3505 Obstetrics & Gynaecology, MFAC3506
Children's Health (Paeds), MFAC3507 Elective, MFAC3508
Emergency/Selective, MFAC3509 Selective, MFAC3510
PRINT, MFAC3511 Phase 3 Portfolio Examination,
MFAC3512 Phase 3 Biomedical Sciences Viva Examination,
and MFAC3513 Phase 3 Integrated Clinical Examination.
Two years: General Medicine and Surgery, Integrated
Community and Child Health, Elective, Senior Medicine
and Surgery – subspecialties in Medicine and Surgery,
Psychological and Addiction Medicine, Women's Health,
and Acute Care.
Four year MBBS (two years): core clinical rotations in Women’s
and Children’s Health, General Practice and Psychological
Medicine. The final year of the course will be structured as a
series of electives where students will choose to complete
their degree by gaining wider experience in chosen disciplines
and specific areas of interest through a range of metropolitan,
rural and overseas settings.
Five year MBBS (Three years): In third year, students will study
integrated medicine and surgery which will be taught together
with a series of problem-based and core-based learning
sessions. The fourth year will be largely taken up with the
core clinical rotations of Women’s and Children's Health and
General Practice and Psychological Medicine. The fifth year
of the course is focused on facilitating the transition of students
into the medical workplace as trainee interns and will be struc-
tured as a series of clinical rotations. Students will consolidate
and enhance their knowledge, clinical skills and professional
behaviours in five clinically orientated rotations: Aged Care,
Emergency Medicine, Medical, Surgical, and Specialty.
Three years: students will expand their knowledge, experience
and skills within these three streams as they undertake
placements within the teaching hospitals and in the broader
medical community.
Continued on page 50
49
 TABLE 26 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

University of Two years: Communication and Clinical Skills, basic Two years: disciplined based clinical placements i.e. Medicine,
Notre Dame Clinical Sciences, Population and Preventative Surgery, Critical Care, etc.
Health, and Personal and Professional Development.

University of Two years: Foundations of Medicine 1 & 2. Three years: integrated clinical rotations.
Western Sydney

University of Three years: Animal and Human Biology, Physiology,
Western Australia Biophysics, Clinical Chemistry, Anatomy, Elements
of Anatomy, Physiology, Biochemistry, Pathology,
Microbiology and Pharmacology.
Three years: years four to six concentrate more heavily on
the clinical aspects of medicine with hospitals and general
practices, both urban and rural. In the penultimate year,
25 per cent of students spend the year at one of the ten rural
clinical sites located throughout the state. The teaching is
structured around blocks of General Medicine, Surgery,
Obstetrics and Gynecology, Pediatrics, Psychiatry, General
Practice and Emergency Medicine. Specialty clinical areas are
also covered. In the final year this block (elective) may be taken
in an overseas centre.

University of Two years: Foundations of Medicine (basic sciences,
Tasmania communication skills, ethics, information literacy, and
community perspectives on health). Fundamentals
of Clinical Science.
Three years : the third year consolidates Fundamentals of
Clinical Science and lays the foundations for clinical practice as
students begin to apply their learning in the clinical setting. In
fourth year, students will rotate through areas such as Medi-
cine, Intensive Care, Obstetrics & Gynecology, Psychiatric
Medicine, General Practice, Emergency Medicine, and Pedi-
atrics & Child Health. The fifth year focuses on consolidating
learning in preparation for hospital practice through a series of
clinical placements, such as Medicine, Surgery & Emergency
Medicine and “buddying” with interns.

University of Two years: basic, clinical, biological and social Two years: clinical rotations within clinical schools.
Queensland sciences, communication skills, ethics and
professional development.

University of Two years: Foundations of Biomedical Science, Two years: Fundamentals of Clinical Practice, Scholarly
Melbourne Fundamental Principles of Clinical Practice, and Selective (research project), and Student Conference.
Student Conference.

Flinders University Two years: Clinical Performance, Knowledge of Two years: clinical rotations (Medicine, Surgery and
of South Australia Health and Illness, Doctor, the Profession and Anaesthesia, Pediatrics and Child Health, Obstetrics and
Society, Doctor and Patient. Gynecology, General Practice, and Psychiatry) and electives.

University of Unknown Unknown

Sydney

Bond University Two years: problem-based learning cases in
subject matter: Anatomy, Biochemistry, Imaging,
Immunology, Microbiology, Pathology, Pharmacol-
ogy, Physiology, Cardiovascular, Endocrine,
Gastroenterology, Hematology, Musculoskeletal,
Neurosciences, Renal, Respiratory, Sexual Health,
and Skin. Communication and History Taking Skills,
and Procedural Skills.
Two years: for most of year three and year four, students
will be located in hospital and community clinical settings.
In year four, there is also an elective term where students
can spend time at any approved hospital post in Australia
or overseas.

Continued on page 51
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 TABLE 26 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

University of Medical Sciences (Anatomy, Physiology, Unknown

Wollongong Biochemistry, Population Health or Behavioural
Science, etc.), Clinical Competencies, Personal
and Professional Development, Research and
Critical Analysis, and Case-Based Learning.

Deakin University Two years: lectures, classes and clinical experience. Two years: Intensive clinical training in health services in
clinical schools. In year four, students are based at public,
private hospitals, and general practices. Program concludes
with two electives, a pre-internship hospital rotation and a
further ambulatory rotation, and an elective that can be
taken in Australia or overseas.

James Cook Three years: Introduction to Integrated Medical Two years: integrated clinical practice and advanced
University Studies, Integrated Human System Pathophysiology, clinical medicine.
Independent Study, Introduction to Clinical
Healthcare, and Integrated Pathology & Clinical
Medicine.

University of Students enroll in six courses in year one, four Clinical exposure begins in the first year and continues
Newcastle courses in years two, four and five, and three throughout the program.
courses in year three.

Although the exact content of the curriculum is based on the length of the medical program, all of the programs begin with a basic
sciences component which educates students in subjects such as Anatomy, Physiology, Biochemistry, etc. Clinical training begins with
clerkship rotations done in Australian hospitals, with the possibility of electives in North American hospitals. Core clerkships are typically
done in Medicine, Surgery and Anesthesia, Pediatrics and Child Health, Obstetrics and Gynecology, General Practice, and Psychiatry.

TABLE 27 ACCREDITATION BY MEDICAL SCHOOL TABLE 28 TUITION BY MEDICAL SCHOOL

Medical School Accreditation and Approvals Medical School Total Tuition Average Yearly
($CAD) Tuition ($CAD)
University of New South Wales Australian Medical Council (AMC)
Australian National University Australian Medical Council (AMC) University of New South Wales $131,538 $21,923
Monash University Australian Medical Council (AMC) Australian National University $193,824 $ 48,456
University of Adelaide Australian Medical Council (AMC) Monash University $213,952* $53,488
University of Notre Dame Australian Medical Council (AMC) University of Adelaide $270,078 $45,013
University of Western Sydney Australian Medical Council (AMC) University of Notre Dame $110,104 $27,526
University of Western Australia Australian Medical Council (AMC) University of Western Sydney $188,340 $37,668
University of Tasmania Australian Medical Council (AMC) University of Western Australia $259,908 $43,318
University of Queensland Australian Medical Council (AMC) University of Tasmania $188,340 $37,668
University of Melbourne Australian Medical Council (AMC) University of Queensland $218,284 $54,571
Flinders University of Australian Medical Council (AMC) University of Melbourne $226,008 $56,502
South Australia Flinders University of South Australia $163,104 $40,776
University of Sydney Australian Medical Council (AMC) University of Sydney $212,448 $53,112
Bond University Australian Medical Council (AMC) Bond University $331,850 $66,370
University of Wollongong Australian Medical Council (AMC) University of Wollongong $75,576 $18,894
Deakin University Australian Medical Council (AMC) Deakin University $187,556 $46,889
James Cook University Australian Medical Council (AMC) James Cook University $203,406 $33,901
University of Newcastle Australian Medical Council (AMC) University of Newcastle $168,000 $33,600
All Australian medical schools are accredited by the Australian * School has more than one program. Total tuition was calculated using four years.
Medical Council (AMC). The total cost for a medical degree from Australia is typically over
$100,000 (CAD).
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 TABLE 29 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

University of New South Wales Australia
Australian National University Australia Clinical teaching facilities within Canberra and in the southeast NSW region.
Monash University Australia Locations throughout eastern and regional Victoria.
University of Adelaide Australia Unknown
University of Notre Dame Australia Unknown
University of Western Sydney Australia Students will be rotating through clinical placements across the whole of Greater
Western Sydney and also possibly rural NSW.
University of Western Australia Australia Unknown
University of Tasmania Australia Unknown
University of Queensland Australia Unknown
University of Melbourne Australia Unknown
Flinders University of South Australia Australia Various locations in South Australia or the Northern Territory.
University of Sydney Australia Unknown
Bond University Australia Various locations in South Australia, Victoria, and Queensland.
University of Wollongong Australia Unknown
Deakin University Australia Unknown
James Cook University Australia Unknown
University of Newcastle Australia Unknown

Clerkship rotations in the clinical years are typically done within Australia, however many schools confirmed that taking electives in
North America is also a possibility.

IRELAND

TABLE 30 IRISH MEDICAL SCHOOL DATA WEBSITE SOURCES

Location Medical School Website

Ireland Trinity College Dublin http://www.medicine.tcd.ie/

Ireland University College Dublin http://www.ucd.ie/medicine/index.html
Ireland Royal College of Surgeons Ireland (RCSI) www.rcsi.ie
Ireland University College Cork http://www.ucc.ie/en/CollegesandDepartments/MedicineandHealth/
Ireland University of Limerick http://www2.ul.ie/web/WWW/Faculties/Education_%26_Health_
Sciences/Departments/Graduate_Medical_School/
Ireland National University of Ireland, Galway http://www.nuigalway.ie/medicine/

TABLE 31 NUMBER OF CSAS STUDYING MEDICINE IN IRELAND

Location Medical School Estimation of CSAs

Ireland Trinity College Dublin ~ 70

Ireland University College Dublin ~ 90
Ireland Royal College of Surgeons Ireland (RCSI) ~ 200
Ireland University College Cork ~ 70
Ireland University of Limerick ~ 50
Ireland National University of Ireland, Galway ~ 20
Ireland Additional Admissions in Sept 2010 ~ 150
Estimated Total ~ 650

Ireland has six medical schools, all of which offer medical education to international students. It is estimated that upwards of
650 Canadians are currently studying medicine in Ireland.

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 TABLE 32 GENERAL INFORMATION
Medical School Year University Founded Year International Program Began

Trinity College Dublin 1592 1953

University College Dublin 1854 1945/2008
Royal College of Surgeons Ireland (RCSI) 1784 1978/2006
University College Cork 1845 1953/2008
University of Limerick 1989 2007
Ireland National University of Ireland, Galway 1845 1953

With the exception of one medical school, all schools in Ireland have been offering medical education to international students
for over 30 years.

TABLE 33 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Available Admissions Fielded Through Admission Requirements

Trinity College Dublin Five year Atlantic Bridge Program Overall average 85%, minimum 80% or better on
a minimum of six subjects over years 11 and 12,
high school transcript, must have courses in
English, math, and a second language.

University College Dublin Four year and six year Atlantic Bridge Program Four year: honors bachelor's degree, and GAMSAT.

Six year: high school diploma.

Royal College of Surgeons Four, five and six year Atlantic Bridge Program Four Year: bachelor’s degree, and MCAT or
Ireland (RCSI) GAMSAT.

Six year: high school transcript, 85% overall

average, must have courses in biology, chemistry,
physics, and math.

University College Cork Four year and five year Atlantic Bridge Program Unknown

University of Limerick Four year Atlantic Bridge Program Bachelor’s degree, MCAT, and interview.

National University of Five year and six year Atlantic Bridge Program General matriculation requirements of the
Ireland, Galway university, English language requirements and
health certificate.

The majority of medical schools in Ireland offer direct entry to medical school out of high school, as well as graduate entry. Standard
admission requirements are an 85% overall average and a high school transcript, or a bachelor’s degree and MCAT or GAMSAT scores.
All North American applications are fielded through the Atlantic Bridge Program.

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 TABLE 34 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

Trinity College Three years: Human Development and Behavioural Science, Evolution and Two years: rotations in Medicine,
Dublin Life, Human Form and Function, Molecular Medicine, Neuroscience, Surgery, Pediatrics, Psychiatry,
Aetiology, Mechanisms and Treatment of Disease I/II, Clinical Skills, Obstetrics and Gynecology,
Pharmacology and therapeutics, Evidence-Based Medicine, Clinical Community Health, General
Medicine and Clinical Surgery. Practice and Ophthalmology/E.N.T.

University College Two years: Physics, Chemistry, Cell Biology, Genetics, Anatomy, Physiology Two years: rotations in Medicine,
Dublin and Biochemistry of Healthy Cells, Tissues and Organ Systems, Patient Surgery, Obstetrics and Gynecol-
Care in Community and Hospital Settings, Pathology, Microbiology and ogy, Pediatrics and Psychiatry, and
Pharmacology, and Diseased Organ Systems. General Practice and Community
Medicine.

Royal College of Two years: Neuromuscular System, Haemapoietic & Immune Systems, Two years: rotations in Medicine
Surgeons Ireland Molecular Medicine, Health Behaviour & Society 1/2, Nutrition & Energy, and Surgery, Medicine and Surgery
(RCSI) Genitourinary System, Clinical Competencies 1/2, Cardiovascular & of Childhood, Obstetrics, Neonatal
Respiratory Systems, Endocrine System, Neuroscience, Evidence Based medicine, Psychiatry, Family
Health, Biology & Epidemiology of Disease, Cardiorespiratory Systems, Practice, Ophthalmology, and
Gastrointestinal & Hepatology Systems, Renal, Endocrine, Genitourinary Oto-rhino-laryngology.
& Breast Systems, Central Nervous and Locomotor Systems, and
Haematolymphoid Systems & Tropical Medicine

University Two/three years: Introductory Human Biology, Cardiovascular, Two years: rotations in Medicine,
College Cork Haematological and Respiratory Biology, Gastrointestinal, Nutritional and Surgery, Obstetrics and
Metabolic Biology, Clinical Science and Practice I/II/III, Person, Culture Gynecology, and Pediatrics.
and Society I/II/III, Neuroscience, Bone Metabolism, Renal Mechanisms
of Homeostasis and Associated Anatomy, Medical Pharmacology,
Mechanisms of Disease, Epidemiology and Public Health Medicine,
General Practice, The Making of the Modern World: Developments in
Art from the Renaissance to the 20th Century, Medicine (Ophthalmology),
Psychiatry, and Surgery (Otorhinolaryngology).

University of Two years: Musculoskeletal System, Rheumatology, Orthopedics, Trauma, Two years: rotations in
Limerick Plastic Surgery, Skin & Dermatology Reproduction & Development, Child General Practice/Primary Care,
Health (Pediatrics), Obstetrics & Gynecology, Sexual Health, Ageing & Obstetrics/Gynecology,
Death, Alimentary System, Gastroenterology, Endocrinology, Renal Pediatrics, Psychiatry, Medicine &
Medicine, Urology, Nutrition, Immunology, Infection, Hematology, Related Specialties, and Surgery
Oncology Preventative Medicine, Genito-Urinary Medicine, Cardiology/ & Related Specialties.
Cardiovascular Surgery, Respiratory Medicine, ENT, Nervous System, Neu-
rology/Neurosurgery, Vision & Ophthalmology, Psychiatry, and Psychology.

National Human Biology, Anatomy, Physiology, Biochemistry, Pharmacology) and Medicine, Surgery, Obstetrics and
University of cognitive sciences (Psychology, Behavioural Sciences, Medical Informatics, Gynecology, Pediatrics, Psychiatry,
Ireland, Galway Ethics, and Health Promotion). Radiology, General Practice, the
Subspecialties, the Clinical
Laboratory Departments and the
Specialist Diagnostic Units.

Irish medical schools also divide studies into basic sciences and clinicals. Both stages of the curriculum are taught in Ireland.

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 TABLE 35 ACCREDITATION BY MEDICAL SCHOOL TABLE 36 TUITION BY MEDICAL SCHOOL

Medical School Accreditation and Approvals Medical School Total Tuition Average Yearly
(Domestic and International) ($CAD) Tuition ($CAD)

Trinity College Dublin Irish Medical Council Trinity College Dublin $209,045 $41,809
University College Dublin Irish Medical Council University College Dublin $189,356* $ 47,339
Royal College of Surgeons Irish Medical Council Royal College of Surgeons $252,204* $63,051
Ireland (RCSI) Ireland (RCSI)
University College Cork Irish Medical Council University College Cork $211,476* $52,869
University of Limerick Irish Medical Council University of Limerick $207,700 $51,925
National University of Irish Medical Council National University of $209,045** $41,809
Ireland, Galway Ireland, Galway

All Irish medical schools are accredited by the Irish * School has more than one program. Total tuition was calculated using four years.
Medical Council. ** School has more than one program. Total tuition was calculated using five years.
The average cost to attend an Irish medical school ranges from
approximately $40,000 (CAD) dollars to $60,000 (CAD) per
year, making Ireland one of the more expensive places to study
medicine internationally.

TABLE 37 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

Trinity College Ireland St. James Hospital, Adelaide and Health Hospital-incorporating the National Children’s
Dublin Hospital, Tallaght (Dublin, Ireland).

University Ireland, US, US: University of Pennsylvania, University of Kansas, University of California,
College Dublin Malaysia San Diego, Emory University and Washington University, St Louis.

Malaysia: Penang Medical College in Malaysia.

Ireland: Mater Misericordiae University Hospital, St. Vincent's University Hospital, the
National Maternity Hospital, the Coombe Women's Hospital, Our Lady's Hopsital for
sick Children and the Children's University Hospital at Temple Street (Dublin, Ireland),
Midlands Regional Hospital (Portlaoise, County Laois, Ireland / Tullamore, County Offaly,
Ireland), Wexford General Hospital (Wexford Town, Wexford, Co Wexford, Ireland),
St. Colmcille's Hospital (Loughlinstown), National Rehabilitation Hospital (Dún
Laoghaire), Mount Carmel (Dublin).

Royal College of Ireland Beaumont Hospital, The James Connolly Memorial Hospital, Routunda Hospital,
Surgeons Ireland National Maternity Hospital, Coombe Women's Hospital, Our Lady's Hospital Crumlin,
(RCSI) Children's Hospital Temple Street, St. Brendan's Hospital (Dublin), Our Lady Lourdes
Hospital (Co. Louth).

University Ireland Bon Secours Hospital, Cork University Hospital, Cork University Maternity Hospital,
College Cork Mercy University Hospital, South Infirmary - Victoria University Hospital, St. Finbarr's
Hospital, St. Mary's Orthopaedic Hospital, St. Patrick's/Marymount (Cork), Mid-Western
Regional Hospital, St. John's Hospital, St. Munchin’s Regional Maternity Hospital
(Limerick), Mallow General Hospital (Mallow, Co. Cork), St. Stephen's Hospital
(Sarsfieldscourt, Cork), Kerry General Hospital (Tralee, Co. Kerry), South Tipperary
General Hospital (Clonmel, Co. Tipperary).

Continued on page 56

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 TABLE 37 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

University of Ireland Midlands Regional Hospital (Mullingar), Midlands Regional Hopsital (Tullamore), Mid-
Limerick Western Maternity Hospital (Limerick Mullingar), Mid-Western Orthopaedic Hospital
(Croom), Mid-Western Regional Hospital, St John’s Hospital (Limerick), Mid-Western
Regional Hospital (Ennis, Co Clare), Mid-Western Regional Hospital (Nenagh, Co Tipperary),
St Luke’s Hospital (Kilkenny), South Tipperary General Hospital (Clonmel).

National Ireland University College Hospital, Merlin Park Regional Hospital (Galway), Altnagelvin Hospital
University of (LondonDerry), Letterkenny General Hospital (Letterkenny), Mayo General Hospital (Castle-
Ireland, Galway bar), Portiuncula Hospital (Ballinasloe), Roscommon County Hospital (Roscommon), Silgo
General Hospital (Silgo), St. Mary’s Hospital (Castlebar), St. Brigid’s Hospital (Ballinasloe).

While the majority of clinical training is done within Ireland, some Irish medical schools have official affiliations with hospitals located in
North America and Malaysia.

POLAND

TABLE 38 POLISH MEDICAL SCHOOL DATA WEBSITE SOURCES

Location Medical School Website

Poland Medical University of Silesia www.slam.katowice.pl

Poland Jagiellonian University Medical College www.medschool.cm-uj.krakow.pl
Poland Poznan University of Medical Sciences http://ump.edu.pl/eng/
Poland Medical University of Bialystok http://ed.umb.edu.pl
Poland Medical University of Lodz www.umed.lodz.pl/eng/
Poland Pomeranian Medical University www.pum.edu.pl
Poland Medical University of Warsaw www.wum.edu.pl/english/
Poland Wroclaw Medical University http://www.am.wroc.pl/en/content/view/19/20/
Poland Medical University of Lublin http://www.umlub.pl/departments_and_courses_id_3927.html
Poland Medical University of Gdańsk www.mug.edu.pl

TABLE 39 NUMBER OF CSAS STUDYING MEDICINE IN POLAND

Location Medical School Estimation of CSAs

Poland Medical University of Silesia ~ 30

Poland Jagiellonian University Medical College ~ 90
Poland Poznan University of Medical Sciences ~ 90
Poland Medical University of Bialystok Unknown*
Poland Medical University of Lodz Unknown*
Poland Pomeranian Medical University Unknown*
Poland Medical University of Warsaw Unknown*
Poland Wroclaw Medical University Unknown*
Poland Medical University of Lublin Unknown*
Poland Medical University of Gdańsk Unknown*
Estimated Total ~ 300
* Unknown denotes locations where CSAs are known to study but no numbers were provided. An overall estimate was given for the region.

A total of 10 medical schools were identified providing medical education to Canadians within Poland. It is estimated that up to
300 Canadians are currently studying medicine in Poland.

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 TABLE 40 GENERAL INFORMATION
Medical School Year University Founded Year International Program Began

Medical University of Silesia 1948 1996

Jagiellonian University Medical College 1364 1994
Poznan University of Medical Sciences 1950 1992
Medical University of Bialystok 1950 2004
Medical University of Lodz 1945 2003
Pomeranian Medical University 1948 1996
Medical University of Warsaw 1816 1993
Wroclaw Medical University 1945 2003
Medical University of Lublin 1950 2001

The Polish medical schools providing medical education to Canadian students have an established history of providing medical
education in English to international students, with the newest program beginning in 2004.

TABLE 41 ADMISSIONS BY MEDICAL SCHOOL

Medical School Programs Admissions Fielded Admission Requirements
Available Through

Medical University Four year Hope Medical Four year: bachelor’s degree
of Silesia and six year Institute Six year: high school diploma
All admission criteria are handled by HMI.

Jagiellonian University Four year and University Four year: bachelor’s degree, MCAT or GAMSAT, Medical College
six year general or organic chemistry, biology, physics, calculus, humanities
or social sciences, and telephone/personal interview.
Six year: high school transcript must have courses in biology,
chemistry, physics, math, admission based on entrance exam.

Poznan University of Four year and University Four year: bachelor’s degree, MCAT, courses in chemistry, biology,
Medical Sciences six year physics, English, and entrance interview.
Six year: high school diploma, courses in physics, chemistry, biology,
mathematics and English, and entrance interview.

Medical University Four year and Hope Medical Four year: official college transcript, high school of transcript, college
Bialystok six year Institute level courses in chemistry, biology, and physics.
Six year: high school transcript, high school level courses in physics,
chemistry, biology and English.

Medical University Six year University Unknown

of Lodz

Pomeranian Medical Six year Hope Medical Unknown

University Institute

Medical University Four year and University Four year: bachelor’s degree, 1200 hours of pre-med courses in
of Warsaw six year chemistry, organic chemistry, biology, physics, calculus, biochemistry,
genetics, or anatomy.
Six year: High school diploma and transcripts, good grades in
chemistry, biology and physics.

Continued on page 58

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57
 TABLE 41 ADMISSIONS BY MEDICAL SCHOOL
Medical School Programs Admissions Fielded Admission Requirements
Available Through

Wroclaw Medical Six year Wroclaw University High school diploma, transcipt, high level grades in English, physics,
University International chemistry, and biology.
Recruitment
Program

Medical University Six year Hope Medical Six year advanced: bachelor of Science with the following courses:
of Lublin advanced and Institute general chemistry, organic chemistry, general biology, general
six year regular physics, and math/calculus. In exceptionally rare instances the
university may consider for admission a well qualified applicant who
completed three years of post-secondary education towards
bachelor’s degree (minimum of 90 credit hours of studies).
Six year regular: high school transcript and diploma are required.

All Polish medical schools offer a six year program with direct entry from high school, however some also offer graduate entry
four year programs. Some admissions are handled by recruitment agencies while some of the universities handle the admissions
themselves. At minimum, a high school diploma is required, while a bachelor’s degree will allow for graduate entry in schools which
offer four year programs.

TABLE 42 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum – includes Core Clinicals and Electives

Medical University Gross Anatomy I/II, Histology I/II, Biophysics, First Aid,
of Silesia Environmental Health, Polish I/II, Immunology,
Biochemistry, Genetics I/II, and Physiology.
Psychiatry, Internal Medicine, Family Practice,
Pediatrics, Surgery, Anesthesiology, Ophthalmology,
Dermatology, Infectious Diseases, Rehabilitation,
Emergency Medicine, Neurology, Neurosurgery, and
Forensic Medicine.

Jagiellonian Anatomy, Clinical Anatomy, Histology I/II, Biochemistry,
University Medical Medical Embryology, Physiology, Radiology, Neuro-
College sciences, Medical Genetics, Immunology, Medical
Ethics, Intro to Clinical Sciences, Cell Biology, Medical
Polish, Behavioral Sciences, Pathomorphology,
Pathophysiology, Pharmacology, and Intro to Surgery.
OB/GYN, Internal Medicine, Anesthesiology and
Intensive Care, Surgery, Pediatrics, Neurology and
Neurosurgery, Psychiatry, Family Medicine, Clinical
Immunology, Emergency Medicine, Rehabilitation,
Oncology, Ophthalmology, Otorhinolaryngology,
Dermatology and Venereology, and Forensic Medicine.

Poznan Gross Anatomy, Histology and Cell Biology, Biochemistry,
University of Human Physiology, Biophysics, Neuroscience, Microbiol-
Medical Sciences ogy, Embryology, Law and Ethics, Medical Sociology,
Pathology, Polish, Pathophysiology, Pharmacology,
Public Health and Epidemiology, Immunology, Biostatis-
tics, Behavioral Science, First Aid, Clinical Diagnosis, and
Internal Medicine.
Pediatrics, OB/GYN, Surgery, Internal Medicine,
Psychiatry, Laboratory Medicine, Family Medicine,
Internal Medicine in Primary Care, Geriatrics, Medical
Polish, Infectious Diseases, Neurology, Radiology,
Forensic Medicine, Oncology, Palliative Care, Tropical
Diseases, Laryngology, Ophthalmology, Orthopedics,
Dermatology, Anesthesiology and Resuscitation.

Medical University Histology, Biophysics, First Aid/Nursing, Anatomy, Internal Medicine, OB/GYN, Nuclear Medicine,
of Bialystok Medical Polish, Physical Education, History of Medicine, General Surgery, Pediatrics, Pediatric Surgery,
Medical Psychology, Biochemistry, Sociology, Physiol- Gerontology, Oncology, Family Medicine,
ogy, Intro to Internal Medicine, Disaster Medicine, Orthopedics, and Ophthalmology.
Pathomorphology, Pathophysiology, Immunology,
Pharmacology, Microbiology, Molecular Medicine,
Hygiene and Epidemiology, Intro to Pediatrics,
Neurology, Clinical Genetics, Emergency Medicine,
Surgery, Radiology, Intro to Dentistry, and Toxicology.
Continued on page 59
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58
 TABLE 42 CURRICULUM SUMMARY BY MEDICAL SCHOOL
Medical School Basic Science Curriculum
Medical University Normal Anatomy, Chemistry, Biology, Bioorganic
of Lodz Chemistry, Biophysics, Physiology Pathomorphology,
Pharmacology, Pathophysiology, Microbiology,
Immunology, and Medical Psychology.
Pomeranian Medical Biology, Medical Chemistry, Propedeutics of Med-
Medical University icine, Anatomy, First Aid with Elements of Nursing , Latin
with Medical Terminology, Physical Education, Biophysics,
Histology & Cytophysiology with Embryology, Computer
Science and Medical Statistics, Sociology, Physiology,
Biochemistry, History of Medicine, Psychology, Immunol-
ogy, Medical Microbiology, Pathophysiology, Epidemiol-
ogy, Pediatrics, Laboratory Diagnostics, Pharmacology,
Parasitology, Oncology, Radiology, and Clinical Genetics.
Medical University Anatomy, Biophysics, Physiology, Parasitology,
of Warsaw Biochemistry, Histology, Embryology, Cytophysiology,
Medical Biology, Medical Ethics, Behavioral Sciences,
Immunology, Polish Language, Latin Language,
Sport Training, Library Training, Pharmacology,
Pathophysiology, Pathomorphology, Microbiology
and Virusology, Neurobiology, Imaging Diagnostics,
Pediatrics Radiology, Laboratory Diagnostics, Hygiene
and Epidemiology, Surgery, Internal Medicine, and
Medical Psychology.
Wroclaw Medical Medical Chemistry (Inorganic And Organic), Biophysics,
University Biology, Anatomy, Histology, Embryology, Genetics,
Immunology, Cytophysiology, Biochemistry, Computing
Techniques, Physiology, Latin, Physical Education, First
Aid and Resuscitation, and Polish.
Medical University Introduction to Biophysics, General Chemistry, General
of Lublin and Analytical Chemistry, Epidemiology, Public Health,
Sources of Literature, Informatics, Introduction to
Medicine, Medical Sociology, Medical Terminology, Latin,
Polish, General Biology, Human Biology with Physiology,
Molecular Biology, Organic Chemistry, Biophysics,
Biostatistics, Introduction to Philosophy, Parasitology,
Hygiene & Nutrition, Ethics, Medical Psychology,
Introduction to Clinical Procedures, Human Anatomy,
Biochemistry, Physiology, Histology, Embryology, First Aid,
Microbiology/ Virology, Pathomorphology, Pathophysiol-
ogy, Pharmacology, Genetics, Immunology, Clinical
Biochemistry, Neuroanatomy, Neuropharmacology,
Physical Diagnosis, and Introduction to Psychiatry.
The Polish medical curriculum is split into two sections: basic sciences and clinical rotations. The basic science curriculum includes
standard courses such as anatomy and physiology; however it also includes Polish language classes. The clinical rotations are done in
Poland, with the option of North American electives. During clinical rotations students are assisted by a Polish translator.
CaRMS Report: 2010
Clinical Curriculum – includes Core Clinicals and Electives
Internal Medicine, Pediatrics, Surgery, Neurology,
Dermatology and Venerology, Endocrinology, and
Infectious Diseases.
Internal Medicine, OB/GYN, Neurology, General
Surgery, Pediatrics, Pediatric Surgery, Gerontology,
Oncology, Family Medicine, Orthopedics, and
Ophthalmology.
Diabetology, Internal medicine, Cardiology, Pulmunol-
ogy, Gastroenterology, Surgery, Oncological Surgery,
Thoracic Surgery, Vascular Surgery, Urology, Orthope-
dics and Traumatology, Obstetrics and Gynecology,
Pediatrics, Nuclear Medicine, Endocrinology, Infectious
Diseases, Nephrology, Rheumatology, Hematology,
Oncology, Dermatology and Venerology, Anesthesiol-
ogy and Intensive Care, Emergency Care, Family
Medicine, Clinical Pharmacology, Forensic Medicine,
Transplantology, Otolaryngology, Clinical Immunology,
Ophthalmology, Pediatrics, Neurology, Psychiatry
(including Child Psychiatry), and Clinical Genetics
Pathology, Pathophysiology, Pharmacology, Microbiol-
ogy , Internal Medicine, General Surgery, Pediatrics,
Gynecology And Obstetrics, Neurology, Dermatology,
Psychiatry, Ophthalmology, Radiology, Otorhinolaryn-
gology, Urology, Pulmonology, Rheumatology, Foren-
sic Medicine, Public Health Medicine, Anesthesiology,
Medical Ethics, and Psychology.
Surgery, Obstetrics/Gynecology, Pediatrics,
Pediatric Family Medicine, Internal Medicine,
Psychiatry, Neurology, Radiology, Nuclear
Medicine, Infectious Diseases, Anesthesiology/
Intensive Care, Dermatology, Otolaryngology,
Oncology, Ophthalmology, Orthopedics/
Rehabilitation, Family Medicine, Emergency
Medicine, Forensic Medicine, and Propedeutics
of Dentistry.
59
 TABLE 43 ACCREDITATION BY MEDICAL SCHOOL
Medical School Accreditation and Approvals (Domestic and International)

Medical University of Silesia ACPUMS & The Polish State Accreditation Committee
Jagiellonian University Medical College ACPUMS & The Polish State Accreditation Committee, US Department of Education and
Medical Board of California
Poznan University of Medical Sciences ACPUMS & The Polish State Accreditation Committee, The Medical Board of California
Medical University of Bialystok ACPUMS & The Polish State Accreditation Committee
Medical University of Lodz ACPUMS & The Polish State Accreditation Committee
Pomeranian Medical University ACPUMS & The Polish State Accreditation Committee
Medical University of Warsaw ACPUMS & The Polish State Accreditation Committee
Wroclaw Medical University ACPUMS & The Polish State Accreditation Committee
Medical University of Lublin ACPUMS & The Polish State Accreditation Committee
All Polish medical schools are accredited by two separate accrediting bodies; some of the medical schools have additionally
sought approval from US departments of education and individual state medical boards.

TABLE 44 TUITION BY MEDICAL SCHOOL

Medical School Total Tuition ($CAD) Average Yearly Tuition ($CAD)

Medical University of Silesia $61,500* $15,375

Jagiellonian University Medical College $63,120* $15,780
Poznan University of Medical Sciences $51,644* $12,911
Medical University of Bialystok $51,252* $12,813
Medical University of Lodz $89,016 $14,836
Pomeranian Medical University Unknown Unknown
Medical University of Warsaw $61,480* $15,370
Wroclaw Medical University $73,500 $12,250
Medical University of Lublin Unknown Unknown
* School has more than one program. Total tuition was calculated using four years.

The cost of medical education for international students in Poland is substantially less than other international locations; in some
cases the entire education in Poland equals one year’s tuition in some of the more expensive countries.

TABLE 45 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

Medical University of Silesia Poland, US - About 60% all clerkships done in US: New York, Illinois, LA.
US/Canada, 40% done in Poland with help of translator Canada: Saskatchewan
Jagiellonian University Medical College Poland, US US: New York, LA, California, San Diego.
Poznan University of Medical Sciences Poland, US, Canada Unknown
Medical University of Bialystok Poland Unknown
Medical University of Lodz Poland Seven teaching hospitals in Poland.
Pomeranian Medical University Poland Unknown
Medical University of Warsaw Poland Five affiliated teaching hospitals in
Warsaw and 16 affiliated hospitals.
Wroclaw Medical University Poland Unknown
Medical University of Lublin Poland Unknown
While a portion of all clerkships are done in Poland, students also have the opportunity to do rotations in US hospitals.

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60
 UNITED KINGDOM (UK)

TABLE 46 UK MEDICAL SCHOOL DATA WEBSITE SOURCES

Medical School Website

Barts and The London School of Medicine and Dentistry www.smd.qmul.ac.uk

University of Leicester http://www.le.ac.uk/sm/le/
University of Cambridge http://www.medschl.cam.ac.uk/
University of Edinburgh http://www.ed.ac.uk/schools-departments/medicine-vet-medicine
University of Aberdeen http://www.abdn.ac.uk/ims/
Warwick Medical School www2.warwick.ac.uk/fac/med/
University of Leeds http://www.leeds.ac.uk/info/20029/faculties/191/faculty_of_medicine_and_health
University of Nottingham http://www.nottingham.ac.uk/mhs/index.aspx
University of Birmingham http://www.medicine.bham.ac.uk/
Imperial College London http://www1.imperial.ac.uk/medicine/
University of Manchester http://www.medicine.manchester.ac.uk/
University of Glasgow http://www.gla.ac.uk/schools/medicine/

Number of CSAs studying medicine in the UK

The number of CSAs studying in the UK are unknown; no schools participated directly in this study and therefore were not
included in the estimated number of Canadians currently studying medicine abroad.

TABLE 47 GENERAL INFORMATION

Medical School Year University Founded Year International Program Began

Barts and The London School of Medicine and Dentistry 1785 Unknown
University of Leicester 1921 Unknown
University of Cambridge 1209 Unknown
University of Edinburgh 1583/1726 Unknown
University of Aberdeen 1495/1497 Unknown
Warwick Medical School 2000 Unknown
University of Leeds 1904 >100 Yrs
University of Nottingham 1948 Unknown
University of Birmingham 1900 Unknown
Imperial College London 1907 Unknown
University of Manchester 2004 Unknown
University of Glasgow 1451 Unknown
Medical University of Lublin Unknown Unknown

Information was not available on when medical schools in the UK began accepting international students.

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61
 TABLE 48 ADMISSIONS BY MEDICAL SCHOOL
Medical School Programs Admissions Fielded Admission Requirements
Available Through

Barts and The London Five year and UCAS Degrees in any discipline are acceptable for five year program.
School of Medicine four year Candidates must have at least an upper second class honours
and Dentistry degree at 2:1. Candidates must be able to demonstrate that they
have reached a satisfactory standard in chemistry and biology, at least
equivalent to AS-level; or applicants must have achieved grades of
BB in AS/A-level chemistry and biology before starting their degree;
or applicants must be completing AS/A levels in chemistry and biology
and achieve BB grades at the time of application.

University of Leicester Five year UCAS International Baccalaureate: Pass Diploma with 36 points including
chemistry and biology at higher level. Grade six required in all subjects.
Other national and international qualifications welcomed. Mature
students welcomed: alternative qualifications considered.

University of Five year UCAS Passes in three of the following: biology/human biology, chemistry,
Cambridge physics, or mathematics. One of the subjects must be chemistry and at
least one pass must be at A level.

University of Edinburgh Five year UCAS Unknown

University of Aberdeen Five year UCAS, the associate UKCAT

dean, along with a
team of members Check with medical admissions office if in doubt about suitability of a
of staff, is responsi- subject. A typical offer will be conditional upon achieving the minimum
ble for managing the requirements for GCE* / SQA / IB / EB applicants or a minimum of the
whole of the annual predicted grades. There may be an English requirement.
admissions cycle.

Warwick Medical School Four year UCAS UCAS, UK Clinical Aptitude Test(UKCAT)

University of Leeds Five year UCAS A Level qualification or equivalent. Minimum requirements are: 6.0
overall on IELTS, with at least 5.5 in listening and reading, and at least
5 in speaking and writing; 220 on computer-based TOEFL (550 on the
paper-based version), with 4.0 on the essay rating (4.0 on the Test of
Written English associated with the paper-based version); 83 on TOEFL
iBT (internet-based), with minimum scores of 18 in listening, 20 in
reading, 20 in speaking and 21 in writing.

University of Four year and UCAS Four year: bachelor's degree.

Nottingham five year Five year: UKAT, Advanced Diploma, International Baccalaureate 36.

University of Five year UCAS Five year: International Baccalaureate Diploma: minimum 36 points
Birmingham including HL chemistry and HL biology.

Imperial College Four year and UCAS Four year: honours degree or a PhD in a biological subject,
London six year and UKCAT.

Six year: International Baccalaureate 38 points in total with a minimum

of six points in each of chemistry and biology, and Biomedical
Admissions Test (BMAT).

Continued on page 63

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62
 TABLE 48 ADMISSIONS BY MEDICAL SCHOOL
Medical School Programs Admissions Fielded Admission Requirements
Available Through

University of Five year and UCAS Five year: International Baccalaureate 37 points, Higher level in
Manchester six year chemistry plus one from either biology, physics or math, plus one
further subject.

Six year: International Baccalaureate 33 points required overall,

Higher Level 665, and Standard Level 655.

University of Glasgow Four year and UCAS - There are Four year: bachelor's degree.
five year only 18 places for
candidates from Five year: UKAT, Advanced Diploma, and International
non-EU countries Baccalaureate 36.

There are a wide range of medical programs available in the UK; all admissions are fielded by a central admissions service: UCAS.

TABLE 49 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

Barts and The Fundamentals of Medicine, Systems in Health, Integrated Clinical Studies, Systems (specialties),
London School of Cardiorespiratory, Metabolism, Locomotor Preparation for Clinical Practice.
Medicine and (Musculoskeletal), Brain and Behaviour (neuroscience,
Dentistry psychology, psychiatry), Human Development
(embryology, reproductive medicine, child health), and
Systems in Disease.

University of Laying the Foundations, Clinical Skills, Medical Sciences, Developing Your Skills, The Learning Environment,
Leicester Social and Behavioural Medicine, Learning How to Elective, Preparing for Postgraduate Training, and
Learn, Learning to Integrate, and Rational Practice. Testing Your Skills: Assessment.

University of Three years: Functional Architecture of the Body Physio- Three years:
Cambridge logical Systems; Molecules in Medical Science, Preparing Stage 1 – Clinical Method
for Patients, Biology of Disease, The Mechanisms of Drug Stage 2 – The Life Course
Action, Neurobiology and Human Behaviour Human Stage 3 – Preparation for Practice
Reproduction, Biological and Biomedical Sciences includ-
ing Pathology, Physiology, Zoology, History and Ethics of
Medicine, to subjects unrelated to medicine such as
anthropology, management studies or philosophy.

University of Two years: Principles of Practice (Anatomy, Physiology,
Edinburgh Pharmacology, Pathology and Microbiology of a
System, along with relevant social and ethical aspects
of clinical practice).
Three years: Process of Care
Further clinical experiences develop skills in
diagnosis and management, building on the
foundation for Principles for Practice but
biomedical and clinical sciences are also revisited
and developed. Students undertake an eight-week
elective in year five. Most split this into two four
week blocks.

Continued on page 64

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 TABLE 49 CURRICULUM SUMMARY BY MEDICAL SCHOOL
Medical School Basic Science Curriculum
University of Two years: Science for Medicine (The Principles and
Aberdeen Vocabulary of Biochemistry, Physiology, Anatomy, Genetics
and other Biomedical Sciences). Integrated teaching of
body systems (Systems II) that began with the Respiratory
and Cardiovascular Systems in year one, Systems Teaching
in Relation to Disease, and Medical Humanities.
Warwick Medical One and a half years: Attending lectures with your fellow
School students, work in small learning groups, guided, as
appropriate, by clinicians or members of Warwick's
academic staff. These groups contain students of different
ages, background and experience, and this method of
working enables everyone to bring their own skills and
knowledge to the group so that students also learn from
one another.
University of Three years: preparing for clinical practice.
Leeds
64
Clinical Curriculum
Three years: Clinical Effectiveness, an apprentice-
ship year in which the student is a junior member
of the healthcare team and develops the generic,
professional skills required in the delivery of health-
care by the multi-professional team. There are four
eight-week blocks which run simultaneously
through the year: Medicine, Surgery, Community
Health (Psychiatry or General Practice), Clinical
Elective, and Professional Practice Block.
Following the four eight-week blocks described
above, this phase is completed before the final
exams with a Professional Practice Block. The eight
key themes are:
Core Knowledge and Skills (with emphasis on non-
technical skills); Clinical Ethics and Law; End of Life;
Prescribing; Handover and Communication; Dealing
with Stress and Conflict; Professional Development
(including careers), and WHO Patient Safety.
Two and a half years: clinical attachments in acute
hospital settings in Coventry, Nuneaton, Redditch,
Rugby and Warwick. Experiences are also provided
in primary and community care placements ranging
from GP practices to outreach projects in the Coventry,
Rugby, Leamington, Warwick and Alcester areas.
Elective: students devise and undertake a medical
project in a setting of their choice. The elective can
be anywhere in the world, subject to suitable
arrangements.
Personal Development Plan: Throughout their time
at Warwick Medical School, students will be asked
to keep a Personal Development Plan (PDP). This is
an opportunity for self-reflection - to think not only
about being a doctor, but about how they fit into
the general healthcare system.
Two years: Clinical Practice in Context, Becoming
a Doctor (communication with patients and other
professionals, medicine in the community, ethics
and law, information technology handling and
management.
Continued on page 65
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 TABLE 49 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Basic Science Curriculum Clinical Curriculum

University of Structure, Function and Pharmacology of Excitable Clinical Practice (Medicine and Surgery), Community
Nottingham Tissues, Molecular Basis of Medicine, Public Health Follow-up, and Therapeutics Obstetrics and Gyne-
Epidemiology, Behavioural Sciences, Human cology, Child Health, Healthcare of the Elderly,
Development and Tissue Differentiation, Early Clinical Psychiatry, Ophthalmology, Otorhinolaryngology
and Professional Development, Clinical Communica- ('Ear, nose and throat'), Dermatology, Special Study
tion Skills, Clinical Laboratory Sciences, Cardiovascular Module Medicine, Surgery, Musculoskeletal Disor-
and Respiratory Systems, Hematology, Renal and ders and Disability, Primary Care (General Practice),
Endocrine Systems, Human Development Structure and Critical Illness and Critical Assistantship.
and Function, Alimentary System and Nutrition,
General and Biochemical Pharmacology, Functional
and Behavioural Neuroscience, Using Epidemiology
in Practice, up to two optional modules Research
Methods, Honours Year Project, Infection, plus two
taught modules.

University of This involves case based learning following a structure Unknown

Birmingham similar to that used in the long established Maastricht
problem-based learning course. Students will work on
the cases as part of a group of about eight students
with a tutor for each group. Each student will cover all
aspects of the cases. The problems are grouped into
four to six-week themed blocks covering basic sci-
ence, Anatomy (including Prosection), Ethics, Medi-
cine in Society, and Behavioural Science with all these
aspects integrated into each of the cases studied.
Over the year students will be working with different
groups of students and with different tutors to prepare
them for the way group working operates within the
health service.

Imperial College Cellular and Molecular Science, Regional and Systems
London Anatomy, Systematic Physiology, Pharmacology and
General Pathology, Introduction to Clinical Practice:
Medical and Surgical Takes (receiving unselected
emergency admissions), GP Teaching (basic clinical
skills/methods in general practice), Patient Clerking,
Consultant Teaching, and other teaching (outpatient
clinic teaching, theatre sessions, endoscopy sessions,
and anaesthetic sessions).
Obstetrics and Gynecology, Pediatrics, Psychiatry,
Oncology, General Practice and Primary Health Care,
Radiology, Infectious Diseases/GUM/HIV, Dermatology,
Rheumatology, Orthopedics, Critical Care, Teaching
Skills Emergency Medicine, General Practice Student
Assistantship, Cardiology, Neurology, Ears, Nose and
Throat, Ophthalmology and, Renal Medicine.

University of Unknown Unknown

Manchester

University of Unknown Unknown

Glasgow

The UK also separates its curriculum by basic sciences and clinical rotations, however many of the medical schools use
problem-based learning (PBL) in the basic science years.

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 TABLE 50 ACCREDITATION BY MEDICAL SCHOOL
Medical School Accreditation and Approvals (Domestic and International)

Barts and The London School of Medicine and Dentistry The General Medical Council, UK
University of Leicester The General Medical Council, UK
University of Cambridge The General Medical Council, UK
University of Edinburgh The General Medical Council, UK
University of Aberdeen The General Medical Council, UK
Warwick Medical School The General Medical Council, UK
University of Leeds The General Medical Council, UK
University of Nottingham The General Medical Council, UK
University of Birmingham The General Medical Council, UK
Imperial College London The General Medical Council, UK
University of Manchester The General Medical Council, UK
University of Glasgow The General Medical Council, UK

All of the medical schools in the UK are accredited by the General Medical Council, UK.

TABLE 51 AVERAGE TUITION BY MEDICAL SCHOOL

Medical School Total Tuition ($CAD) Average Yearly Tuition ($CAD)

Barts and The London School of Medicine and Dentistry $139,328* $34,832
University of Leicester $158,725 $31,745
University of Cambridge $253,560 $42,260
University of Edinburgh $216,590 $43,318
University of Aberdeen $146,940 $29,388
Warwick Medical School $143,996 $35,999
University of Leeds $115,275 $23,055
University of Nottingham $125,908* $31,477
University of Birmingham $138,158 $27,630
Imperial College London $257,380* $64,345
University of Manchester $174,380** $34,876
University of Glasgow $138,716* $34,679

* School has more than one program. Total tuition was calculated using four years.
** School has more than one program. Total tuition was calculated using five years.

Tuition costs in the UK are similar to those found in Ireland; they range from $23,000 (CAD) per year to
upwards of $43,000 (CAD) per year.

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 TABLE 52 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

Barts and The London School of Great Britain Royal London and Barts, the Homerton Hospital, Newham General
Medicine and Dentistry and Whipps Cross University Hospital, as well as a number of other
hospitals in Greater London and Essex.

University of Leicester Great Britain Glenfield Hospital, Leicester General Hospital, Leicester Royal Infirmary

University of Cambridge Great Britain Addenbrooke's Hospital

University of Edinburgh Great Britain Royal Infirmary Edinburgh and Western General Hospital

University of Aberdeen Great Britain Dr. Gray's Hospital, Elgin and Raigmore Hospital, Inverness, and all students
undertake hospital-based clinical placements outside Aberdeen.

Warwick Medical School Great Britain University Hospitals Coventry and Warwickshire NHS Trust

University of Leeds Great Britain General Infirmary adjacent to the Worsley Building, St James’s
University Hospital, Bradford Teaching Hospital.

Students also spend time in other hospitals across West Yorkshire:

Airedale hospital near Keighley, Calderdale (Halifax) and Huddersfield
hospitals to the west, Pinderfields (Wakefield), Dewsbury and Pontefract
hospitals just to the south of Leeds and Harrogate hospital, north of
Leeds. General practices across West Yorkshire and beyond provide a
variety of placements.

University of Nottingham Great Britain Nottinghamshire, Derbyshire and Lincolnshire.

University of Birmingham Great Britain Unknown

Imperial College London Great Britain Unknown

University of Manchester Great Britain, Central Manchester, University Hospitals NHS Foundation Trust,
Europe Lancashire Teaching Hospitals NHS Foundation Trust, Salford Royal
NHS Foundation Trust, University Hospital of South Manchester NHS
Foundation Trust

University of Glasgow Great Britain Unknown

Clerkship rotations are done at affiliated hospitals in the UK and Europe.

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 EUROPE/MIDDLE EAST

TABLE 53 EUROPE/MIDDLE EAST MEDICAL SCHOOL DATA WEBSITE SOURCES

Location Medical School Website

Lithuania Kaunas University of Medicine http://naujas.kmu.lt

Romania University of Medicine and Pharmacy Iuliu Hatieganu www.umfcluj.ro
Egypt University of Cairo http://cuportal.cu.edu.eg
Iran Islamic Azad University www.iau.ac.ir
Bahrain RCSI Bahrain www.rcsi-mub.com
Israel Sackler School of Medicine http://medicine.tau.ac.il
Israel Ben-Gurion University of the Negev http://cmsprod.bgu.ac.il/eng/fohs
Israel Technion Israel Institute of Technology http://md.technion.ac.il/

TABLE 54 NUMBER OF CSAS STUDYING MEDICINE IN EUROPE/MIDDLE EAST

Location Medical School Estimation of CSAs

Lithuania Kaunas University of Medicine Unknown*

Romania University of Medicine and Pharmacy Iuliu Hatieganu Unknown*
Egypt University of Cairo Unknown*
Iran Islamic Azad University Unknown*
Bahrain RCSI Bahrain ~ 50
Israel Sackler School of Medicine ~ 20
Israel Ben-Gurion University of the Negev Unknown*
Israel Technion Israel Institute of Technology Unknown*
Estimated Total ~ 70
* Unknown denotes locations where CSAs are known to study but no numbers were provided. An overall estimate was given for the region.

Eight areas within Europe and the Middle East were identified as educating Canadian students, which led to an estimate of
approximately 70 Canadians currently studying there.

TABLE 55 GENERAL INFORMATION

Medical School Year University Founded Year International Program Began

Kaunas University of Medicine 1919 Unknown

University of Medicine and Pharmacy Iuliu Hatieganu 1919 Unknown
University of Cairo 1837 Unknown
Islamic Azad University 1361 Unknown
RCSI Bahrain 2004 2004
Sackler School of Medicine 1964 1976
Ben-Gurion University of the Negev 1969 Unknown
Technion Israel Institute of Technology 1924 Unknown

Most of the medical schools identified in Europe and the Middle East have been providing medical education in excess of 40 years.
Although RCSI Bahrain was founded in 2004, it is a partner of RCSI located in Ireland, which is a well-established institution.

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 TABLE 56 ADMISSIONS BY MEDICAL SCHOOL
Medical School Programs Admissions Fielded Admission Requirements
Available Through

Kaunas University Six year Unknown In-person interview required, physical exam/health records, transcript
of Medicine and written application.

University of Medicine Six year University based Unknown

and Pharmacy Iuliu
Hatieganu

University of Cairo Six year Unknown Unknown

Islamic Azad University n/a International Affairs Unknown

of the Islamic Azad
University

RCSI Bahrain Five year and Unknown Five year program: bachelor's degree, and MCAT.
six year Six year program: high school examinations with a minimum average
score of 85% and competitive grades in biology, chemistry, physics
and mathematics.

Sackler School of Four year The New York City State/American Program.
Medicine office of the Sackler Bachelor’s degree, MCAT, courses in English, inorganic chemistry,
School of Medicine organic chemistry, physics and biology.
has sole responsibility
for the admission of
students into the
New York

Ben-Gurion University Four year Unknown Bachelor's degree, GPA, MCAT scores, extra-curricular experience,
of the Negev recommendations, and interview assessments.

Technion Israel Institute Unknown Unknown Unknown

of Technology

The majority of schools offer one medical program, however RCSI Bahrain offers two different streams. Admission is primarily based
on high school transcripts, a bachelor’s degree and MCAT scores.

TABLE 57 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical Curriculum – includes Core Clinicals and Electives

Kaunas University of Two years: theoretical disciplines on
Medicine medicine such as Human Anatomy,
Histology-Embryology, Physiology, both
chemistry, physics, foreign languages,
and philosophy are subjects of first and
second year studies.
Three years: clinical medicine subjects begin during third
year studies and include such disciplines as Medical
Diagnostics, General Surgery, patient care, and others.
Fourth year studies cover such disciplines as Internal
Diseases, Infectious Diseases, Dermato-Venerology,
Psychiatry, and fifth year covers the following subjects:
Surgery, Obstetrics-Gynecology, Nervous Diseases,
Neurosurgery, Ophthalmology, Anesthesiology and
Intensive Care. During last (sixth) year of undergraduate
studies the program contains disciplines such as Pediatrics,
Emergency Medicine, Social Medicine, Public Health,
Family Medicine, and others.

Continued on page 70
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69
 TABLE 57 CURRICULUM SUMMARY BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical Curriculum – includes Core Clinicals and Electives

University of Medicine Unknown Unknown

and Pharmacy Iuliu
Hatieganu

University of Cairo Two years: first year Anatomy, first year Two years: fourth year Community Medicine & Public Health,
Medical Physiology, first year Medical fifth year Community Medicine & Public Health, Pediatrics,
Biochemistry and Molecular Biology, first Internal Medicine, and General Surgery.
year Histology, second year Anatomy,
second year Medical Physiology, second
year Medical Biochemistry and Molecular
Biology, second year Histology,
Computer; Psychology and Behavioral
Sciences, Microbiology and Immunology,
third year Community Medicine& Public
Health; Medical Parasitology; Clinical
Pharmacology, Pathology, Ear, Nose and
throat (E.N.T.), Ophthalmology, Forensic
Medicine and Clinical Toxicology.

Islamic Azad University Unknown Unknown

RCSI Bahrain Neuromuscular, Biomedicine, Haemo-
topoietic and Immune Systems, Health
Behavior and Society, Clinical Competen-
cies, Molecular Medicine, Neuroscience,
and Epidemiology.
Medicine and Surgery, OB/GYN, Neonatal Medicine,
Psychiatry, Family Practice, Ophthalmology, and
Otolaryngology.

Sackler School of Biochemistry, Cell Biology, Genetics, Internal Medicine, OB/GYN, Pediatrics, Psychiatry, Surgery,
Medicine Molecular Biology, Gross Anatomy, Emergency Medicine, Family Medicine, Neurology, and
Embryology, Histology, Pharmacology, Medicine.
Microbiology, Neurology, Pathology,
Epidemiology, Genetics, and Physical
Diagnosis.

Ben-Gurion University of Unknown Unknown

the Negev

Technion Israel Institute Unknown Unknown

of Technology

The curriculum is broken up into basic sciences and clinical rotations as is the case with all other international medical schools.

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 TABLE 58 ACCREDITATION BY MEDICAL SCHOOL
Medical School Accreditation and Approvals (Domestic and International)
Kaunas University of Medicine Unknown
University of Medicine and Pharmacy Iuliu Hatieganu Unknown
University of Cairo Unknown
Islamic Azad University Unknown
RCSI Bahrain GCC Medical Schools Deans’ Committee
Sackler School of Medicine Council for Higher Education, New York State Education Department, State of Israel
Ben-Gurion University of the Negev Council for Higher Education
Technion Israel Institute of Technology Council for Higher Education
Accreditation is varied and dependent on the location of the medical school.

TABLE 59 TUITION BY MEDICAL SCHOOL

Medical School Total Tuition ($CAD) Average Yearly Tuition ($CAD)
Kaunas University of Medicine Unknown Unknown
University of Medicine and Pharmacy Iuliu Hatieganu $42,036 $ 7,006
University of Cairo Unknown Unknown
Islamic Azad University Unknown Unknown
RCSI Bahrain $191,225 $38,245*
Sackler School of Medicine $ 114,576 $28,644
Ben-Gurion University of the Negev $ 60,468 $15,117
Technion Israel Institute of Technology Unknown $ 23,339
* School has more than one program. Average yearly tuition was calculated using five years.

Tuition data was not available for all of the schools identified. The Israeli schools tended to have lower tuition rates while RCSI
Bahrain was similar to rates found in Ireland.

TABLE 60 CLERKSHIPS BY MEDICAL SCHOOL

Medical School Clerkship Locations Clinical and Affiliated Hospital Locations

Kaunas University of Medicine Lithuania KMUK, LITHUANIAN HPH Hospitals

University of Medicine and Pharmacy Iuliu Hatieganu Romania Unknown

University of Cairo Egypt Kasr Al Ainy Hospital

Islamic Azad University Iran 24 hospital complex

RCSI Bahrain Bahrain, International Locations King Hamad General Hospital

Sackler School of Medicine Israel, US Teaching institutions whose departments are

affiliated with Sackler include seven major
medical centers, six psychiatric hospitals, 20
research institutes and a large rehabilitation center.

Ben-Gurion University of the Negev Israel Unknown

Technion Israel Institute of Technology Israel Unknown

Clinical rotations are typically done within the country of medical education, although a couple of schools do state that international
and US locations are available for a portion of the clinical rotations.

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 INTERNATIONAL MEDICAL SCHOOL DATA - MEDICAL SCHOOL SURVEY RESULTS
The following data are derived from the 20 international medical schools that participated in the medical school survey.

SURVEY RESPONDENTS

TABLE 61 LOCATION OF SURVEY RESPONDENTS

Country Medical School n

Caribbean Ross University 3

Australia Flinders University of South Australia 1
Australia University of Sydney 2
Australia University of Queensland 1
Australia University of Wollongong 1
Australia James Cook University 1
Bahrain RCSI Bahrain 1
Ireland University of Limerick 1
Ireland Royal College of Surgeons in Ireland 1
Ireland Trinity College, University of Dublin 1
Ireland University College Cork 1
Ireland University College Dublin 1
Israel Sackler School of Medicine 1
Poland Jagiellonian University Medical College 1
Poland Medical University of Silesia, School of Medicine in Katowice 1
Poland Poznan University of Medical Sciences Center for Medical Education 1
Czech Republic Charles University 1

A total of 90.0% of the medical schools that responded to the school survey were those that were visited in person. This demonstrates
that on-site visits played a critical role in this study.

TABLE 62 ROLE OF SURVEY RESPONDENTS

Role of Respondent n %
Dean 4 20%
Professor 8 40%
Administration 2 10%
Director of Curriculum Development 1 5%
Clinical Associate Lecturer 1 5%
Unknown 4 20%
Total 20 100%

Medical school deans and professors were the two most likely to answer the medical school survey.

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MOTIVATION TO RECRUIT INTERNATIONAL MEDICAL STUDENTS

Apart from fiscal reasons, when surveyed about motivation, a ride range of reasons were given as to why international
medical students are recruited:
Australia Caribbean
• “Adds to the breadth of backgrounds of students in the • “There is a great need for doctors and schools within the
program - which is particularly good in a PBL format.” USA and Canada have not been supplying enough to meet
• “Diversity of student population - as seen in Canadian this need for decades.”
applicant pool. We like the ethnic and cultural mix.” • “Since the number of positions available in medical schools in
the US and Canada is limited, many well qualified and highly
Ireland
motivated students would otherwise be unable to study
• “To forge relationships with other countries.”
medicine. Schools like Ross provide students with that
Poland opportunity.”
• “Main goal is not to just send physicians back to Canada, • “Quality of faculty, accelerated program, beauty of island.”
but to send highly educated and good physicians back.
Czech Republic
Money is not the main reason for IMGs.”
• “It is a good motivation for teachers and our national students
• “Clinical opportunities, North American trained faculty.”
to have large spectrum of nationalities in our medical degree
Middle East programs.”
• “A desire to establish a long lasting connection for primarily
(but not exclusively) Jewish-American and Canadian students
with Israel.”

Regions of Recruitment

While over 50 countries were named, the most frequently chosen countries for recruitment were Canada and the United States.

International student training capacity

The main reasons cited that affect how many international medical students are trained abroad were the physical capabilities
of training facilities and the limited number of faculty available to train students. On average, 17.8% of international medical
school faculty are North American trained.

TABLE 63 FACTORS THAT INFLUENCE THE NUMBER OF INTERNATIONAL STUDENTS TRAINED

Factors n %

Physical capacity (i.e. lecture halls) 10 34%

Number of faculty available to train international students. 5 17%
Accreditation limits 7 24%
Other 7 24%
Total 29 100%
* Respondents were able to choose more than one answer.

Factors that influence international student training capacity by medical school region:
Ireland • Accreditation limits (n =1).
• Number of faculty available to train international students (n =1). • Staff teach block based (n =1).
• Accreditation limits (n = 3). • Government funding (n =1).
• Clinical resources (n = 1). • Keeping small numbers for clinical placements & PBL (n = 1).
• Clinical, rural exposure (n = 1).
Poland
• Physical capacity (n = 3). Middle East
• Availability of resources (n = 1). • Physical capacity (n = 1).
• Accreditation limits (n = 1).
Caribbean • Number of faculty available to train international students (n = 1).
• Physical capacity (n = 3). • Market factaors, supply and demand, ability to speak Arabic. (n =1).
• Accreditation limits (n = 1).
Czech Republic
Australia • Number of faculty available to train international students (n = 1).
• Physical capacity (n = 3). • Accreditation limits (n = 1).
• Number of faculty available to train international students (n = 2).
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 TABLE 64 INTENTION TO CHANGE THE SIZE OF INTERNATIONAL MEDICAL TRAINING PROGRAMS

n %
Yes 8 50%
No 8 50%
Total 16 100%
While some medical schools noted future expansion, including increasing the enrolment of Canadian students and opening new
campuses, many cited a decrease in their international medical program due to government restrictions.

Intention to change the size of the international medical training programs by medical school region:
Ireland Australia
• Reduce size (n = 2) • No change (n = 3).
• Expand program (n = 2).
Poland
• Expand program (n = 1). Middle East
• No change (n = 2). • No change (n = 2).

Caribbean Czech Republic

• Expand program (n = 2). • No change (n = 1).
• Reduce size (n = 1).

TABLE 65 EXPECTED CHANGES IN LEGISLATION THAT WILL IMPACT INTERNATIONAL MEDICAL TRAINING PROGRAMS

n %
Yes 5 31%
No 11 69%
Total 16 100%
Changes in residency, clerkships and rural rotations where domestic students are favoured over international students,
was the main reason cited as impacting IMG training programs abroad.

Expected changes in legislation that will impact international medical training programs by medical school region:
Ireland - Closure of internships.
• No expected changes in legislation (n = 1) - Increased competition for rural rotations as half of the
placements must have 25% Aussies.
Poland - Permanent residents and citizens of Australia have priority
• No expected changes in legislation (n = 3) for residency positions.
- Program is currently provisional going to full accreditation
Caribbean in 2011.
• No expected changes in legislation (n = 3)
Middle East
Australia • No expected changes in legislation (n = 2)
• No expected changes in legislation (n = 1)
• Expected changes in legislation (n = 5). Czech Republic
- International students do not have access to 1 year • No expected changes in legislation (n = 1)
rural remote location placement opportunities.

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MEDICAL DEGREE PROGRAMS AND ADMISSION REQUIREMENTS BY MEDICAL SCHOOL REGION

TABLE 66 AVAILABLE MEDICAL DEGREE PROGRAMS AND ADMISSION REQUIREMENTS BY MEDICAL SCHOOL REGION
Medical School Medical Degree Example of Admission Requirements
Region Programs

Ireland Four year Bachelor's degree, MCAT or GAMSAT, Health Professionals Admissions Test – Ireland exam.
Five year Overall average 85%, high school transcript, must have English, math, and second language.
Six year High school transcript, 85% overall average, must have biology, chemistry, physics, and math.
Admissions test (HPAT-Ireland).

Poland Four year Bachelor's degree, college diploma, college-level courses in chemistry, biology, and physics.
Six year High school transcript; high school level courses in physics, chemistry, biology and English.

Caribbean Four year Bachelor's degree, MCAT or GAMSAT, courses in chemistry, biology, physics, math, English,
MCAT, GPA, SAT/ACT.
Five year Bachelor's degree, courses in chemistry, biology, physics, math, English, MCAT, GPA, SAT.

Australia Four year MCAT or GAMSAT, GPA.

Five year High school diploma, high school courses in English, chemistry and biology, ISAT.
Six year High school cumulative average 85% or above, if have post-secondary education, GPA of 75% or above.

Middle East Four year Bachelor's degree, MCAT, one year or six credits in English, inorganic chemistry, organic chemistry,
physics and biology.
Five year Bachelor's degree, MCAT.
Six year High school examinations with a minimum average score of 85%, high school courses in biology, c
hemistry, physics and math.

Admission procedures

When asked how applicants were selected, 46.0% of the schools cited an interview and 42.0% cited marks beyond having the
basic admission requirements.

TABLE 67 ADDITIONAL ADMISSION PROCEDURES BY REGION OF MEDICAL SCHOOL

Medical School Region Admission Procedures Medical School Region Admission Procedures

Ireland • Marks (n = 2) Caribbean • Marks (n = 2)

• Interview (n = 2) • Interview (n = 2)
• Applicants observed in group
exercise (n = 1) Australia • Marks (n = 3)
• No interview (n = 1) • Interview (n = 3)

Poland • Interview (n = 3) Middle East • Marks (n = 2)

• About 10% of applicants are • Interview (n = 1)
rejected (n = 1)
Czech Republic • Marks (n = 1)
• Interview (n = 1)

A total of 84.0% of the schools surveyed reported that their programs are competitive among international students; however,
none of the medical schools reported international students competing against domestic students for medical school spots.
Interestingly, 20.0% of the medical schools surveyed stated that the admission requirements were the same for both international
and domestic students.

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 TABLE 68 DO ADMISSIONS CRITERIA DIFFER FOR INTERNATIONAL STUDENTS VERSUS NATIONAL STUDENTS?

n %
Yes* 9 45.0%
No** 4 20.0%
N/A 7 35.0%
Total 20 100%

* Schools that had different admissions criteria for international and national students: Ireland (n = 1), Poland (n = 2), Australia (n = 5), Middle East (n = 1).
** Schools that did not have different admissions criteria for international and national students: Caribbean (n = 2), Middle East (n = 1).

Admission differences reported by region of medical school were:

Ireland • “Local students must sit the Australian admissions test, GAMSAT.
• “Irish/EU based on GM, top accepted.” International applicants may sit GAMSAT or MCAT.”
• “Marks for international students tend to be lower.”
Poland
• “Completely different, MCAT, undergrad GPA, interview, Middle East
volunteer work.” • “Our national students undergo a day long process after initial
• “English program is not open to Polish students.” screening with high school grades and a psychometric exam score.
They have at least four methods of assessment including personal
Australia interview, group simulation, and individual simulation with SP's.”
• “Domestic students must pass GAMSAT - Canadians or IMGs
do not.”

Admissions committee

TABLE 69 ADMISSIONS COMMITTEE REPRESENTATIVES

n %
Medical School Faculty 14 56%
Deans of Medical School 4 16%
Other 7 28%
While 72% of the representatives on the admissions committees were cited as medical school faculty and/or deans, others included
recruitment agencies such as The Atlantic Bridge Program for Ireland medical school admissions, and Hope Medical Institute for
some Polish medical school admissions. Additionally, there were physician recruiters located in North America.

TUITION

When asked whether or not tuition costs differed for international students versus domestic students, 60% of the medical schools surveyed
answered yes. The most commonly cited reason was financial gain, as a majority of the medical schools surveyed were located in countries
were domestic medical students do not pay tuition, or pay a small amount and the remainder is subsidized by the government.

TABLE 70 AVERAGE YEARLY TUITION

Medical School Region Avg. Yearly Tuition ($CAD)

Ireland $49,800
Poland $14,191
Caribbean $25,608
Australia $42,334
Middle East $26,336

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 POSTGRADUATE TRAINING
Eight of the schools surveyed stated that they offer career
counselling to assist students in finding postgraduate
residency training.
Availability of postgraduate training abroad:
• Ireland – EU citizens get first priority.
• Poland – Must speak Polish, requires separate examination
that is not required for graduation, must be an EU citizen.
• Australia – Australian citizens/permanent residents get
first priority.
• Caribbean – No postgraduate training available.
• Bahrain - No postgraduate training for CSAs.
REFERENCES
1 Health Canada. OECD Health Data 2010, Statistics and
Indicators. Available at : www.oecd.org/publishing
2 The Association of Faculties of Medicine of Canada. Moving
the Health Human Resource Agenda Forward, Submission to
the House of Commons Standing Committee on Health From
the Association of Faculties of Medicine of Canada (AFMC).
December 2009.
3 Banner S, Comeau M. Analysis of the 2006 Survey of
Canadians Studying Medicine and the medical schools
training Canadians Outside of Canada and the U.S.. Final
Report to Health Canada 2006:1-20.
CaRMS Report: 2010
4 Collier R. Medical school admission targets urged for rural
and low-income Canadians. CMAJ 2010; 182(8): 327-328.
5 The Association of Faculties of Medicine of Canada. Canadian
Medical Education Statistics 2009. Volume 31. Available at:
http://www.afmc.ca/pdf/cmes/CMES2009.pdf. Accessed
August 2010.
6 CaRMS 2010 Canadian Medical Graduate Cohort Data.
Accessed June-August 2010.
7 Merani M, Abdulla S, Kwong JC, Rosella L, Streiner DL,
Johnson IL. Increasing tuition fees in a country with two
different models of medical education. Medical Education
2010; 44: 577-586.
8 Clark C. Increasing US Medical School Spots Won’t Increase
Physician Supply. Health Leaders Media 2010. Accessed
August 2010. Available at:
http://www.healthleadersmedia.com/content/PHY-250808/
Increasing-US-Medical%20School
77
 APPENDIX – ANALYSIS RESULTS

AGE BY MEDICAL SCHOOL REGION

Medical School Region Age

24 and under 25 - 29 30 - 34 35 - 44 45 and over Total

n % n % n % n % n % n %
Western Europe 100 36.8% 148 54.4% 22 8.1% 1 0.4% 1 0.4% 272 100%
Eastern Europe 24 30.4% 47 59.5% 7 8.9% 1 1.3% 79 100%
Caribbean 218 43.5% 234 46.7% 38 7.6% 9 1.8% 2 0.4% 501 100%
Australia 21 10.2% 149 72.3% 27 13.1% 9 4.4% 206 100%
Middle East 9 39.1% 14 60.9% 23 100%

a) Chi-square test:
Is there a relationship between age groups across medical school
regions? Yes. A chi-square test of independence was done to see
whether age groups are related to medical school region. The
results of the test were significant,X2 (20, n = 1082) = 96.07,
p < .001. These results indicate that there are age differences
across medical school regions. When the chi-square test of
independence indicated an overall significant relationship
between medical school region and age group, a z-test for
proportions was done to test for significant differences in age
across medical school regions.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences in
age across medical school regions. From the graph and tables,
Australia seems to have a smaller group of CSAs in the ’24 and under’
age group compared to other medical school regions. To test for
significant differences a total of four comparisons were made in the
’24 and under’ age group: Australia versus Ireland, Australia versus
Poland, Australia versus Caribbean, and Australia versus Middle East.
With the number of comparisons, a Bonferonni correction was ap-
plied to control for Type 1 error. For testing significant differences, all
p values must be less than 0.0125 (.05/4) to be considered significant.
For the ’24 and under’ age group, there were significant differences
between Australia and all other regions: Ireland (z = 6.51, p < .001),
Poland (z = 4.003, p < .001), Caribbean (z = 8.423, p < .001), Middle
East (z = 3.576, p < .001). Australia had a significantly smaller propor-
tion of the youngest CSAs (10.2%) compared to other medical school
regions for the 24 and under age group.

AGE – 2010 CSAS VERSUS CMGs

Group Age (Years)

20 - 25 26 - 30 31 - 40 41 - 50 Total
n % n % n % n % n %
CSA 115 10.6% 799 73.9% 160 14.8% 7 0.6% 1081 100.0%
CMG 826 45.3% 845 46.4% 140 7.7% 11 0.6% 1822 100.0%
Total 1361 1312 214 17 2904

a) Chi-square test:
Is there a relationship between age and group (CSAs or CMGs)?
Yes. The result chi-square test of independence was significant, X2
(3, n = 2903) = 376.09, p < .001. These results indicate that there
is a relationship between age and group.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences
in age groups across CSAs and CMGs. To test for significant differ-
ences a total of three comparisons were made in the following age
groups: 20-25 years, 26-30 years, and 31-40 years. A Bonferonni
correction was applied to control for Type 1 error. For testing
significant differences, all p values must be less than 0.02 (.05/3) to
be considered significant.
There were significant differences in all comparisons. There is a
significant difference between CSAs and CMGs in the 20 – 25
age group (z = 19.264, p < .001). There is a significant difference
between CSAs and CMGs in the 26 – 30 age group (z = 14.43,
p < .001). There is a significant difference between CSAs and CMGs
in the 31 - 40 age group (z = 6.029, p < .001).

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 GENDER BY MEDICAL SCHOOL REGION

Medical School Gender

Region Male Female Total
n % n % n %
Ireland 117 43.0% 155 57.0% 272 100%
Poland 43 54.4% 36 45.6% 79 100%
Caribbean 282 56.3% 219 43.7% 501 100%
Australia 114 55.3% 92 44.7% 206 100%
Middle East 12 52.2% 11 47.8% 23 100%

a) Chi-square test:
Is there a relationship between the number of males and females
across medical school regions? Yes. A chi-square test of independ-
ence was done to whether there is a relationship between genders
across medical school regions. The results of the test were significant,
X2 (4, n = 1081) = 13.48, p < .05. These results indicate that there are
gender differences across medical school regions. To provide more
specific information about these gender differences across regions, a
z-test for two proportions was conducted..
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences
in gender differences across medical school regions. A total of five
comparisons were made across gender: Ireland, Poland, Caribbean,
Australia, and Middle East. With the number of comparisons, a
Bonferonni correction was applied to control for Type 1 error. For
testing significant differences, all p values must be less than 0.01
(.05/5) to be considered significant.
For gender, there were significant differences between the propor-
tion of males to females in Ireland (z = 3.566, p < .001). In Ireland
there are more females than males (30.2% versus 20.6%). There
were no significant differences between males and females across
the other medical school regions.

GENDER – 2010 CSAS VERSUS CMGs

Group Gender
Male Female Total
n % n % n %
CSA 568 52.5% 514 47.5% 1082 100.0%
CMG 751 41.8% 1047 58.2% 1798 100.0%
Total 1319 1561 2880

a) Chi-square test:
Is there a relationship between gender and group (CSA or CMG)?
Yes. A chi-square test of independence was done to see whether
gender is related to being a CSA or CMG. The results of the test
were significant, X2 (1, n = 2880) = 31.31, p < .001. These results
indicate that there are gender differences by group.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences
in gender across the CSA or CMG group. To test for significant
differences a total of two comparisons were made: differences in the
proportion of males between the CSA and CMG group, and differ-
ences in proportion between females between the CSA and the
CMG group. A Bonferonni correction was applied to control for
Type 1 error. For testing significant differences, all p values must
be less than 0.025 (.05/2) to be considered significant.
There were significant differences in the proportion of males between
CSAs and CMGs (z = 5.559, p < .001). There were significant
differences in the proportion of females between CSAs and CMGs
(z = 5.559, p < .001).

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 MARITAL STATUS BY MEDICAL SCHOOL REGION

Marital Status
Region of Medical School Single Married/Living with a partner Separated/Divorced Total
n % n % n % n %
Ireland 233 85.7% 39 14.3% 0 0 272 100.0%
Poland 65 82.3% 14 17.7% 0 0 79 100.0%
Caribbean 426 85.0% 70 14.0% 5 1.0% 501 100.0%
Australia 146 70.9% 58 28.2% 2 1.0% 206 100.0%
Middle East 21 91.3% 2 8.7% 0 0 23 100.0%

a) Chi-square test: With the number of comparisons, a Bonferonni correction was

Is there a relationship between marital status and medical school
region? Yes. A chi-square test of independence was done to see
whether marital status is related to medical school region. The results
of the test were significant, X2 (8, n = 1081) = 27.97, p < .001. These
results indicate that there are marital status differences across medical
school regions.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences in
marital status across medical school regions in the married/living with
a partner category. To test for significant differences a total of four
comparisons were made: Australia versus Ireland, Australia versus
Poland, Australia versus Caribbean, and Australia versus Middle East.
applied to control for Type 1 error. For testing significant differences,
all p values must be less than 0.0125 (.05/4) to be considered
significant.
For the ‘Married/Living with a partner’ group, there were significant
differences between the Australia and Ireland (z = 3.606, p < .001).
There were also significant differences between Australia and the
Caribbean (z = 4.345, p < .001) for the proportion of CSAs in the
‘Married/Living with a partner’ category. Australia has a larger group
of CSAs that are married or living with a partner than CSAs in Ireland
and the Caribbean. There were no significant differences between
Australia and Poland or Australia and the Middle East in the married
or living with a partner category.

MARITAL STATUS – 2010 CSAS VERSUS CMGs

Group Marital Status

Single/Divorced/Separated/Widower Married/Living with partner Total
n % n % n %
CSA 899 83.1% 183 16.9% 1082 100%
CMG 1115 61.6% 695 38.4% 1810 100%
Total 2014 878 2892

a) Chi-square test: ‘Single/Divorced/Separated/Widowed’ status of CSAs versus

Is there a relationship between marital status and group (CSA or
CMG)? Yes. A chi-square test of independence was done to see
whether marital status is related to being a CSA or CMG. The
results of the test were significant, X2 (1, n = 2892) = 147.85,
p < .001. These results indicate that there are differences.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences
in marital status across the CSA or CMG group. To test for
significant differences between CSAs and CMGS a total of two
comparisons were made across the marital status groups:
CMGs, and ‘Married/Living with partner’ status of CSAs versus
CMGs. A Bonferonni correction was applied to control for Type 1
error. For testing significant differences, all p values must be less
than 0.025 (.05/2) to be considered significant.
For the ‘Single/Divorced/Separated/Widowed’ group there were
significant differences between CSAs and CMGs (z = 12.12,
p < .0001). There were significant differences in the proportion
of those married/living with partner between CSAs and CMGs
(z = 12.12, p < .0001).

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 CSAs WITH PARENTS WHO ARE PHYSICIANS BY REGION

Medical School Parent(s) Medical Doctor

Region Yes No Total
n % n % n %
Ireland 87 31.64% 185 68.36% 272 100%
Poland 18 22.78% 61 77.22% 79 100%
Caribbean 79 15.77% 422 84.23% 501 100%
Australia 39 18.93% 167 81.07% 206 100%
Middle East 4 17.39% 19 82.61% 23 100%
Total 227 857 1081

a) Chi-square test:
Is there a relationship between having a parent or both parents a
medical doctor and medical school region? Yes. A chi-square test
of independence was done to see whether parent(s) is a medical
doctor is related to medical school region. The results of the test
were significant, X2 (4, n = 1081) = 28.91, p < .001. These results
indicate that there are differences whether a parent(s) is a medical
doctor or not across medical school regions.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences
across medical school regions. Looking over the graph, CSAs from
Ireland seem to have a higher proportion of having a parent or par-
ents as a medical doctor compared to other medical school regions.
To test for significant differences a total of four comparisons were
made: Ireland versus Poland, Ireland versus Caribbean, Ireland versus
Australia, and Ireland versus Middle East. With the number of
comparisons, a Bonferonni correction was applied to control for Type
1 error. For testing significant differences, all p values must be less
than 0.0125 (.05/4) to be considered significant.
For looking at whether CSAs in Ireland had a significantly larger
proportion of parent(s) as a medical doctor than CSAs in other med-
ical school regions, there were significant differences between Ireland
and the Caribbean (z = 5.153, p < .001) and Ireland and Australia (z =
3.105, p < .01). There were no significant differences between Ireland
and Poland or Ireland and the Middle East for whether CSAs in
Ireland had a larger proportion of parent(s) as a medical doctor. CSAs
in Ireland had a significantly higher proportion of a parent or parents
as a medical doctor than CSAs in the Caribbean or Australia.

POST-SECONDARY EDUCATION IN CANADA BY MEDICAL SCHOOL REGION

Medical School Post-secondary Education in Canada

Region Yes No Total
n % n % n %
Ireland 219 80.5% 53 19.5% 272 100%
Poland 66 83.5% 13 16.5% 79 100%
Caribbean 470 93.8% 31 6.2% 501 100%
Australia 202 98.1% 4 1.9% 206 100%
Middle East 20 87.0% 3 13.0% 23 100%

a) Chi-square test:
Is there a relationship between having a post-secondary education
in Canada and medical school region? Yes. A chi-square test of
independence was done to see whether having a post-secondary
education or not is related to medical school region. The results of
the test were significant, X2 (4, n = 1081) = 55.76, p < .001. These
results indicate that having a post-secondary education in Canada
varies across medical school regions.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant differences
across medical school regions. To test for significant differences a total
of four comparisons were made: Ireland versus Poland, Ireland versus
Caribbean, Ireland versus Australia, and Ireland versus Middle East.
With the number of comparisons, a Bonferonni correction was applied
to control for Type 1 error. For testing significant differences, all p
values must be less than 0.0125 (.05/4) to be considered significant.
For looking at whether CSAs in Ireland had a significantly lower
proportion of attending a post-secondary education in Canada com-
pared to CSAs in other medical school regions, we found that there
were significant differences between Ireland and the Caribbean (z =
5.553, p < .001) and Ireland and Australia (z = 5.721, p < .001). There
were no significant differences between Ireland and Poland or Ireland
and the Middle East in the number of CSAs having a post-secondary
education in Canada. CSAs in Ireland had a significantly lower
proportion of having a post-secondary education in Canada than
CSAs in the Caribbean or Australia.

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 HIGHEST LEVEL OF EDUCATION BY MEDICAL SCHOOL REGION
Highest Level of Education Ireland Poland Caribbean Australia Middle East
n % n % n % n % n %

High school 43 15.8% 10 12.7% 6 1.2% 4 1.9% 1 4.2%

Post-secondary community college 1 0.4% 2 0.4% 1 0.5% 0
Some university (no degree) 21 7.7% 11 13.9% 12 2.4% 2 1.0% 5 20.8%
Bachelor’s degree 167 61.4% 54 68.4% 397 79.2% 166 80.6% 13 54.2%
Master’s degree 37 13.6% 4 5.1% 67 13.4% 30 14.6% 4 16.7%
Ph.D. or equivalent 3 1.1% 10 2.0% 3 1.5% 1 4.2%
Other 7 1.4%
Total 272 79 501 206 24

a) Chi-square test:
Is there a relationship between CSAs highest level of post-secondary
education in Canada and medical school region? Yes. A chi-square
test of independence was done to see whether having a post-
secondary education or not is related to medical school region.
The results of the test were significant, X2 (24, n = 1081) = 142.05,
p < .001. These results indicate that the highest level of post-
secondary education of CSAs varies across medical school regions.
b) Significant differences in proportions:
Of interest is the comparison of bachelor degrees across medical
school regions. A z-test for proportions was done to test for significant
differences across medical school regions. To test for significant differ-
ences a total of four comparisons were made: Australia versus Ireland,
Australia versus Poland, Australia versus the Caribbean, and
Australia versus the Middle East. With the number of compar-
isons, a Bonferonni correction was applied to control for Type 1
error. For testing significant differences, all p values must be less
than 0.0125 (.05/4) to be considered significant.
For looking at whether CSAs in Australia had a significantly higher
proportion of having a bachelor degree compared to CSAs in other
medical school regions, we found that there were significant differences
between Australia and Ireland (z = 4.417, p < .001) and Australia and
Poland (z = 2.688, p < .01). There were no significant differences in the
proportion of CSAs having a bachelor’s degree between Australia and
the Carribean or Australia and the Middle East. CSAs in Australia had a
significantly higher proportion education than CSAs in Europe.

CMA AND CMG COMPARISON – HIGHEST LEVEL OF EDUCATION PRIOR TO ATTENDING MEDICAL SCHOOL
Highest Level of Education Prior to Attending Medical School
Group Secondary Post Secondary 2 years or less 3 years or more Bachelor's Master's Ph.D., Other Total
education (e.g. community in university of university Degree Degree Ed. D. or
college) (no degree) (no degree) equivalent

n % n % n % n % n % n % n % n % n %

CSA 64 5.9% 4 0.4% 30 2.8% 21 1.9% 797 73.7% 142 13.1% 17 1.6% 7 0.6% 1082 100%
CMG 15 0.8% 264 14.5% 68 3.7% 129 7.1% 1109 60.9% 179 9.8% 52 2.9% 5 0.3% 1821 100%
Total 79 268 98 150 1906 321 69 12 2903

a) Chi-square test:
Is there a relationship between highest level of education and group
(CSA or CMG)? Yes. A chi-square test of independence was done to
see whether the highest level of education prior to attending medical
school is related to being a CSA or CMG. The results of the test were
significant, X2 (7, n = 2903) = 278.47, p < .001. These results indicate
that there is a relationship between being a CMG or CSA and the
highest level of education prior to medical school.
b) Significant differences in proportions:
The z-test for proportions was done to test for significant differences
in highest level of education prior to medical school across the CSA
or CMG group. To test for significant differences between CSAs and
CMGS a total of five comparisons were made across the groups:
‘High School’, ‘College’, ‘Bachelor’s degree’, ‘Master’s Degree’, and
‘Ph.D. or equivalent’. A Bonferonni correction was applied to control
for Type 1 error. For testing significant differences, all p values must
be less than 0.01 (.05/5) to be considered significant.
There were significant differences across four of the five compar-
isons. CSAs and CMGs were significantly different for: high school
(z = 8.032, p < .0001), college (z = 12.65, p < .0001), bachelor’s
degree (z = 6.96, p < .0001), and master’s degree (z = 2.72,
p < .01). There were no significant differences between CSAs and
CMGs for Ph.D. or equivalent (z = 2.08, p = .04).

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 APPLICATION TO CANADIAN MEDICAL SCHOOLS BY HIGHEST LEVEL OF EDUCATION PRIOR TO ATTENDING MEDICAL SCHOOL
Highest Level of Education
How Many Times High School College Some Bachelor's Master's Ph.D., Other Total
Applied to Canadian university Degree Degree or
Medical School (no degree) equivalent
Before Going Abroad
n % n % n % n % n % n % n % n

Did not apply 61 95.3% 2 50.0% 43 84.3% 166 20.8% 12 8.5% 1 5.9% 4 57.1% 289
Applied once 2 3.1% 2 50.0% 6 11.8% 357 44.8% 27 19.0% 4 23.5% 2 28.6% 400
Applied 2x or more 1 1.6% 0 0.0% 2 3.9% 274 34.4% 103 72.5% 12 70.6% 1 14.3% 393
Total 64 100% 4 100% 51 100% 797 100% 142 100% 17 100% 7 100% 1082

a) Chi-square test:
Is there a relationship between highest level of education and
application to Canadian medical schools? Yes. A chi-square test of
independence was done to see whether the highest level of educa-
tion prior to attending medical school is related to the number of
times a CSA applied to a Canadian medical school before going
abroad. The results of the test were significant, X2 (12, n = 1082) =
361.51, p < .001. These results indicate that there is a relationship
between the number of times a CSA applied to a Canadian medical
school before going abroad and their highest level of education.
b) Significant differences in proportions:
The z-test for proportions was done to test for significant differences
in highest level of education prior to medical school for the CSA
group that did not apply to any Canadian medical school. To test for
significant differences in this group a total of two comparisons were
made: Bachelor’s degree versus high school, and bachelor’s degree
versus Master’s degree. A Bonferonni correction was applied to
control for Type 1 error. For testing significant differences, all p values
must be less than 0.025 (.05/2) to be considered significant.
There were significant differences across both comparisons. For
CSA that did not apply to a Canadian medical school, there is a
significant difference between those with a bachelor’s degree and
those with a high school degree (z = 12.86, p < .001). There is also
a significant difference between those with a bachelor’s degree and
those with a master’s degree (z = 3.35, p < .001). In the ‘Did not
apply’ category, there were more CSAs with a high school degree
than those with a bachelor’s degree, and there were less CSAs with
a master’s degree than bachelor’s degree.

APPLICATION TO CANADIAN MEDICAL SCHOOLS BY REGION OF MEDICAL SCHOOL

Number of Times Applied

Medical School Region Did not apply Applied once Applied 2x or more Total
n % n % n % n %
Ireland 79 29.0% 89 32.7% 104 38.2% 272 100%
Poland 43 54.4% 23 29.1% 13 16.5% 79 100%
Caribbean 118 23.5% 216 43.1% 167 33.3% 501 100%
Australia 40 19.4% 65 31.6% 101 49.0% 206 100%
Middle East 8 34.8% 7 30.0% 8 35.0% 23 100%
Total 288 400 393 1081

a) Chi-square test:
Is there a relationship between the number of times a CSA applied
to a Canadian medical school before going abroad by region? Yes.
A chi-square test of independence was done to see whether
number of times applied to Canadian medical schools is related to
medical school region. The results of the test were significant, X2
(8, n = 1081) = 59.40, p < .001. These results indicate that the
number of times applied varies across medical school regions.
b) Significant differences in proportions:
A z-test for proportions was done to test for significant
differences across medical school regions. To test for significant
differences a total of eight comparisons were made. In the ‘Did
not apply’ category we compared Poland to the other regions
(Ireland, Caribbean, Australia, and Middle East). In the ‘Applied
2x or more’ category we compared Australia to the other
regions (Ireland, Poland, Caribbean, Middle East). With the
number of comparisons, a Bonferonni correction was applied to
control for Type 1 error. For testing significant differences, all p
values must be less than 0.006 (.05/8) to be considered significant.
For the ‘Did not apply’ category, there were significant differences
between Poland and Ireland (z = 4.038, p < .001), Poland and
the Caribbean (z = 5.561, p < .001), and Poland and Australia
(z = 5.677, p < .001). There were no significant differences between
Poland and the Middle East for the ‘Did not apply’ category
(z = 1.422, p = .155). For the ‘Applied 2x or more’ category, there
were significant differences between Australia and Poland (z =
5.677, p < .001). There were no significant differences between
Australia and Ireland (z = 2.302, p = .021), Australia and the
Caribbean (z = 1.098, p = .272), and Australia and the Middle
East (z = 1.446, p = .148).

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 SATISFACTION WITH MEDICAL DEGREE PROGRAM BY MEDICAL SCHOOL REGION
Satisfaction with Medical Degree Program

Medical School Region Satisfied Neutral Dissatisfied Total

n % n % n % n %
Ireland 254 93.4% 12 4.4% 6 2.2% 272 100%
Poland 73 92.4% 5 6.3% 1 1.3% 79 100%
Caribbean 469 93.6% 22 4.4% 10 2.0% 501 100%
Australia 177 85.9% 18 8.7% 11 5.3% 206 100%
Middle East 20 87.0% 3 13.0% 0 0.0% 23 100%
Total 993 60 28 1081

a) Chi-square test:
Is there a relationship between levels of satisfaction with medical
degree program and region of medical school? Yes. A chi-square
test of independence was done to see if satisfaction is related to
region of medical school. The results of the test were significant,
X2 (8, n = 1081) = 17.10, p < .05. These results indicate that there
is a relationship between region of medical school and levels of
satisfaction with medical program.
b) Significant differences in proportions:
The z-test for proportions was done to test for significant
differences in satisfaction between Australia and other regions.
To test for significant differences between regions in the
‘Satisfied’ category, a total of four comparisons were made across
the groups: Australia versus Ireland, Australia versus Poland,
Australia versus the Caribbean, and Australia versus the Middle
East. A Bonferonni correction was applied to control for Type 1
error. For testing significant differences, all p values must be less
than 0.0125 (.05/4) to be considered significant.
There were significant differences across two regions. CSAs in
Australia are significantly less satisfied than CSAs inIreland
(z = 2.56, p = .0106), and CSAs in Australia are significantly less
satisfied than CSAs in the Caribbean (z = 3.16, p < .01). There
were no significant differences in satisfaction between Australia
and Poland (z = 1.29, p = .196) and between Australia and the
Middle East (z = -0.18, p = .857).

DIFFICULTY IN ARRANGING A CLERKSHIP ROTATION IN CANADA BY MEDICAL SCHOOL REGION

Difficulty in Arranging a Clerkship Rotation in Canada

Medical School Region Easy Okay Difficult Total

n % n % n % n %
Ireland 18 26.9% 19 28.4% 30 44.8% 67 100%
Poland 3 25.0% 4 33.3% 5 41.7% 12 100%
Caribbean 0 0.0% 7 17.5% 33 82.5% 40 100%
Australia 10 21.3% 14 29.8% 23 48.9% 47 100%
Total 31 44 91 166

a) Chi-square test: Caribbean to Australia, Caribbean to Ireland, and Caribbean to

Is there a relationship between levels of difficulty in arranging a
clerkship rotation in Canada across medical school regions? Yes.
A chi-square test of independence was done to see if there is a
relationship between level of difficulty and medical school region.
The results of the test were significant, X2 (6, n = 166) = 19.52,
p < .05. These results indicate that levels of difficulty in arranging
a clerkship rotation is related to medical school regions.
b) Significant differences in proportions:
Of interest is whether there are significant differences across
medical school regions for the “Difficult’ category. A z-test for
proportions was done to test for significant differences between
the proportions. A total of three comparisons were made:
Poland. With the number of comparisons, a Bonferonni correction
was applied to control for Type 1 error. For testing significant
differences, all p values must be less than 0.0166 (.05/3) to be
considered significant.
For the ‘Difficult’ category there is a statistically significant
difference across all regions. CSAs from the Caribbean found it
more difficult to arrange clerkship positions than CSAs in:
Australia (z = 3.033, p < .01), Ireland (z = 3.633, p < .001), and
Poland (z = 2.426, p = .0153).

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 POPULAR FUNDING TYPE BY MEDICAL SCHOOL REGION
Popular Funding Types
Medical School Family Bank Loan Government Personal International Bank Loan Other Total
Region Savings in Canada Grants Savings Scholarships Elsewhere
n % n % n % n % n % n % n % n %

Ireland 229 38.4% 171 28.7% 75 12.6% 81 13.6% 5 0.8% 19 3.2% 16 2.7% 596 100%
Poland 53 33.3% 45 28.3% 24 15.1% 29 18.2% 2 1.3% 4 2.5% 2 1.3% 159 100%
Caribbean 315 26.9% 375 32.0% 202 17.2% 134 11.4% 67 5.7% 37 3.2% 42 3.6% 1172 100%
Australia 142 27.8% 146 28.6% 102 20.0% 88 17.3% 9 1.8% 9 1.8% 14 2.7% 510 100%
Middle East 21 45.7% 11 23.9% 4 8.7% 6 13.0% 1 2.2% 2 4.3% 1 2.2% 46 100%

a) Chi-square test:
Is there a relationship between popular funding types and med-
ical school regions? Yes. A chi-square test of independence was
done to see if there is a relationship between the types of fund-
ing that CSAs used towards their medical education and medical
school region. The results of the test were significant, X2 (24, n =
2483 = 91.44, p < .001. These results indicate that the most
popular type of funding is related to medical school region.
b) Significant differences in proportions:
With family savings being the most popular type of funding over
a majority of medical school regions, the z-test for proportions
was done to test for significant differences. To test for significant
differences in the ‘Family Savings’ category a total of four
comparisons were made across the groups: Ireland versus Poland,
Ireland versus Caribbean, Ireland versus Australia, Ireland versus
the Middle East. A Bonferonni correction was applied to control
for Type 1 error. For testing significant differences, all p values
must be less than 0.0125 (.05/4) to be considered significant.
There were significant differences across two of the four compar-
isons. Ireland was significantly different from the Caribbean in the
use of family savings to fund their medical education (z = 4.915,
p < .0001). Ireland was significantly different from Australia (z =
3.651, p < .001). In both comparisons to CSAS in the Caribbean
and Australia, family savings was more popular in Ireland than the
Caribbean and Australia. Ireland was not significantly different
from Poland (z = 1.087, p = 0.277). Ireland was not significantly
different from the Middle East (z = 0.812, p = 0.417).

SATISFACTION WITH COST OF MEDICAL EDUCATION BY MEDICAL SCHOOL REGION

Medical School Region Satisfaction with Cost of Medical Education

Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied Total

n % n % n % n % n % n %
Ireland 4 1.5% 53 19.5% 120 44.1% 95 34.9% 272 100%
Poland 34 43.0% 28 35.4% 13 16.5% 4 5.1% 79 100%
Caribbean 89 17.8% 119 23.8% 113 22.6% 126 25.1% 54 10.8% 501 100%
Australia 2 1.0% 14 6.8% 55 26.7% 87 42.2% 48 23.3% 206 100%
Middle East 1 4.3% 4 17.4% 12 52.2% 5 21.7% 1 4.3% 23 100%
Total 126 169 246 342 198 1081

a) Chi-square test:
Is there a relationship between satisfaction with the cost of med-
ical education to medical school region? Yes. A chi-square test of
independence was done to see if there is a relationship between
level of satisfaction and medical school region. The results of the
test were significant, X2 (16, n = 1081) = 356.67, p < .001. These
results indicate that levels of satisfaction with the cost of medical
education are related to medical school regions. To provide more
specific information about these differences, a z-test of propor-
tions was conducted.
b) Significant differences in proportions:
Of interest is whether there are significant differences across
medical school regions for the “Dissatisfied’ category. A z-test for
proportions was done to test for significant differences between
the proportions. A total of four comparisons were made:
Caribbean to Australia, Caribbean to Ireland, Caribbean to
Poland, and Caribbean to Middle East. With the number of
comparisons, a Bonferonni correction was applied to control for
Type 1 error. For testing significant differences, all p values must
be less than 0.0125 (.05/4) to be considered significant.
For the ‘Dissatisfied’ category there is a statistically significant
difference between CSAs from the Caribbean and Ireland
(z = 5.327, p < .001) and between CSAs from the Caribbean and
Poland (z = 3.835, p < .001). CSAs in the Caribbean were not
significantly different in their levels of dissatisfaction with CSAs
from Australia and the Middle East.

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 SATISFACTION WITH MEDICAL PROGRAM BY SATISFACTION BY COST OF MEDICAL EDUCATION
Satisfaction with Satisfaction with Cost of Medical Education
Medical Program
Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied Total
n % n % n % n % n % n %
IVery satisfied 79 18.0% 62 14.2% 120 27.4% 118 26.9% 59 13.5% 438 100%
Satisfied 46 8.3% 97 17.4% 111 20.0% 193 34.7% 109 19.6% 556 100%
Neutral 2 3.3% 7 11.7% 13 21.7% 24 40.0% 14 23.3% 60 100%
Dissatisfied 2 9.5% 2 9.5% 5 23.8% 12 57.1% 21 100%
Very dissatisfied 1 14.3% 2 28.6% 4 57.1% 7 100%
Total 127 169 246 342 198 1082

a) Chi-square test: b) Significant differences in proportions:

Is there a relationship between a CSAs satisfaction with their medical
program and satisfaction with the cost of medical education? Yes. A
chi-square test of independence was done to see if there is a
relationship between level of satisfaction and medical school region.
The results of the test were significant, X2 (16, n = 1082) = 76.07,
p < .001. These results indicate that satisfaction with their medical
program and levels of satisfaction with the cost of medical education
are related. The results indicate that higher levels of dissatisfaction
with the cost of medical education are related to higher levels
dissatisfaction with their medical program.
Of interest is whether there are significant differences between CSAs
that were very dissatisfied with their medical program and CSAs that
were very satisfied with their medical program under the group of CSAs
that were very dissatisfied with the cost of their medical education.
For the ‘Very Dissatisfied with the Cost of their Medical Education’
category there is a statistically significant difference between CSAs
that were very satisfied with their medical program and CSAs that
were very dissatisfied with their medical program (z = 2.742, p < .05).
CSAs that were very dissatisfied with the cost of their education were
also very dissatisfied with their medical program.

YEAR OF GRADUATION BY INTENTION TO RETURN TO CANADA TO PURSUE POSTGRADUATE MEDICAL TRAINING

Year of Graduation Intention to Return to Canada for Training

Yes No Total
n % n % n %
2010 98 77.8% 28 22.2% 126 100%
2011 146 87.4% 21 12.6% 167 100%
2012 281 92.7% 22 7.3% 303 100%
2013 317 91.6% 29 8.4% 346 100%
2014 125 96.9% 4 3.1% 129 100%
2015 9 90.0% 1 10.0% 10 100%
Total 976 105 1081

a) Chi-square test:
Is there a relationship between year of graduation with intention to
return to Canada to pursue postgraduate training? Yes. The results of
the test were significant, X2 (5, n = 1082) = 33.25, p < .001. These
results indicate that year of graduation is related to intention to return
to Canada for postgraduate training. To provide more specific informa-
tion about these differences, a z-test of proportions was conducted.
b) Significant differences in proportions:
A total of three comparisons were made. For CSAs intending to return
to Canada we compared 2010 versus 2011, 2010 versus 2014.
Comparisons to 2015 were not done due to the small number of CSAs
graduating in that year. For CSAs intending not to return to Canada we
looked at the significant difference between 2010 and 2014. With the
number of comparisons, a Bonferonni correction was applied to control
for Type 1 error. For testing significant differences, all p values
must be less than 0.017 (.05/3) to be considered significant.
For CSAs intending to return to Canada to pursue postgraduate training,
there is a statistically significant difference between CSAs graduating in
2010 and 2014 (z = 4.419, p < .001). The closer CSAs are to graduating
the less likely they plan on returning to Canada for postgraduate training.
There is no difference between the proportion of CSAs graduating in 2010
and 2011 in their intention to return to Canada.
For CSAs intending to not to return to Canada to pursue postgraduate
training, there is a statistically significant difference between CSAs
graduating in 2010 and 2014 (z = 4.419, p < .001). Again, the closer
CSAs are to graduating the less likely they plan on returning to Canada
for postgraduate training.

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86
 REGION OF MEDICAL SCHOOL BY INTENTION TO RETURN TO CANADA TO PURSUE POSTGRADUATE MEDICAL TRAINING

Medical School Intention to Return to Canada for Training

Region Yes No Total
n % n % n %
Ireland 255 93.8% 17 6.3% 272 100%
Poland 65 82.3% 14 17.7% 79 100%
Caribbean 454 90.6% 47 9.4% 501 100%
Australia 182 88.3% 24 11.7% 206 100%
Middle East 20 87.0% 3 13.0% 23 100%
Total 976 105 1081

Is there a relationship between intention to return to Canada to region. The results of the test were significant, X2 (4, n = 1081) =
pursue postgraduate training and medical school region? Yes. 10.73, p < .001. These results indicate that CSAs across all regions
A chi-square test of independence was done to see if there is a plan on returning to Canada for their postgraduate training.
relationship between intention to return and medical school

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87