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Less science, more diversity: How Canadian medical school admissions are changing


When Melissa Shears applied to medical school, it felt like a lottery. “You hear the numbers of how many people apply, and how many people get in – it’s quite overwhelming,” she says. But now the first year Queen’s medical student has a different perspective.

“I think they look for people with really diverse and dynamic experiences, and less of a cookie cutter application,” she says. She believes her work on programs with special needs children and adults set her apart – along with her obvious passion and long-term commitment to that work.

Now that she’s at Queen’s, it feels a lot less like luck got her there. “The school looks for very specific things, and they’ve really put an effort into refining the process.”

At schools across the country, traditional entrance measurements for medical students are being questioned. Research has revealed that some aren’t very effective at choosing applicants who will develop into excellent physicians. Other procedures unfairly exclude minority groups or create a medical school class that’s overly homogenous.

As a result, some universities have dropped science as an entrance requirement, skipped the Medical College Admission Test (MCAT) or swapped out the traditional panel interview. Here’s what they’re doing instead.

Why are admissions so important?

In some schools in Europe, large cohorts of students are accepted into medical school, and the weeding out process happens during school, as students compete to be able to graduate. But in Canada, more than 98% of medical students graduate. That means the biggest barrier for them to become doctors isn’t graduating – it’s getting in in the first place. And that places a huge burden on schools to figure out how to select the best students.

“In our current construct, really what we’re doing in admissions is deciding who’s going to enter the profession,” says Geneviève Moineau, CEO of the Association of Faculties of Medicine of Canada. “That’s why we need to try our very best to get it right.”

That’s made more difficult by the fact that getting into medical school is now so competitive that the schools are choosing between top-notch students. Ontario medical schools only accepted 14% of applicants in 2015.

Schools facing this task are working backwards from a bigger question: What makes a good doctor? The University of Toronto has looked to the CanMEDS framework, offered by the Royal College of Physicians and Surgeons of Canada. In addition to good scholars, it argues, doctors need to be professional, communicate and collaborate well, show leadership and advocate for healthier societies. High quality care requires not just medical expertise but also these soft skills.

Swapping interviews for the MMI and personal essays for CASPer

The traditional way to judge motivation, maturity or interpersonal skills has been an autobiographical sketch in the application, and an interview afterwards. At many schools, after students pass the minimum grade requirements, the interview is the most important factor in deciding if students get in.

But does it work? The evidence is mixed. Structured interviews, which include standardized questions and sample answers for interviewers to judge against, are best, with raters often agreeing in their judgments. Multiple interviewers or multiple interviews also increase accuracy. But overall, being assigned to a hard or easy interviewer can make a large difference in ratings for the whole panel, and there’s evidence that an interview is too short a time for candidates to properly show off their abilities.

In response to these issues, McMaster developed the Multiple Mini Interview (MMI) in 2002. It includes eight to 10 interview stations staffed by different judges, where students share what they would do in a hypothetical situation. The concept is that this will reduce the benefit candidates would have from rehearsing answers to stock questions, like ‘Why do you want to be a doctor?’ and force more honest, impromptu answers.

Students might face questions such as how to choose between giving a transplant to a successful elderly person or a drug-addicted 20-year-old, or what they would do if a family member decided to treat a major illness with only alternative medicine. Judges are normally from the school, but at the Northern Ontario School of Medicine, they include Aboriginal elders and people from the Francophone community as well. “We want to get a broad perspective from community members on who would be appropriate for their community,” says David Marsh, deputy dean and associate dean for community engagement at NOSM.

The MMI is more predictive of success in medical school than the MCAT or GPA scores. It’s also a good predictor of success on the Objective Structured Clinical Examination (OSCE) exam, which has been linked to doctors having fewer complaints to regulatory medical authorities and better indicators of primary care, such as more appropriate medication prescribing and higher cancer screening rates.

The MMI is used at a dozen schools in Canada, including McGill, UBC, the University of Alberta, and the University of Montreal, as well as over 30 schools in the U.S. The University of Toronto does a “modified MMI” that uses four personal interviews.

Schools face a similar problem using personal statements during the screening process. They’re not predictive of preclinical performance, raters often don’t agree on their rankings, and they’re difficult to compare because of the non-standardized nature of the answers. More importantly, many students get help writing them: One study found that more than 40% of medical students had input from others on their personal statements.

That’s why McMaster created a screening tool, CasPER, to replace the personal statement. The 90-minute online test is similar to the MMI, asking candidates how they would respond to 10 to 12 different scenarios, each of which is graded by a different marker. But it’s relatively new and has been less widely implemented. McMaster has been using it for four years, and the University of Ottawa began using it this year.

Dropping science prerequisites and questioning the role of the MCAT

Some schools are debating dropping the traditional science prerequisites. The University of Alberta is among them. “We have dropped all pre-requisites, as have many schools across the country,” says Marc Moreau, assistant dean of admissions at the Faculty of Medicine and Dentistry. “We are hoping it will increase the number of students from other faculties applying to medicine, increasing our diversity.”

McMaster, the Northern Ontario School of Medicine, Queen’s University, the University of Alberta and UBC all don’t have a science prerequisite for their medical programs. At the University of Toronto, successful applicants don’t need physics or chemistry, but they are required to have two life sciences credits. The University of Calgary also doesn’t require sciences – and in internal analyses, the school found that there was no relationship between the number of science courses students had taken and how well they performed in the program.

That holds true across other schools as well, says Harold Reiter, director of educational research and development in the Faculty of Health Sciences at McMaster. “There are a number of articles looking at students from non-science backgrounds. The first year or two of medical school is more stressful for them, but once they get to the third of fourth year of medical school, they’ve caught up. And there is tremendous untapped potential there in terms of non-science students enriching medical practice and the world of medicine.”

Of course, a science background is also important for the MCATs – and the test could act as a de facto screen against humanities graduates. That’s McMaster uses only the Critical Analysis and Reasoning score from the test.

In a sense, the MCAT works – a 2007 meta-analysis found that MCAT scores predicted performance at medical school and on medical board licensing exams. But it’s biased against certain groups, including black and Latino students, and those who speak English as a second language.

It’s also not available in French. For that reason, French medical schools and the bilingual University of Ottawa don’t require it, and McGill dropped the test in 2010. The English Northern Ontario School of Medicine also doesn’t use it. “We think the MCAT is biased against Aboriginals and Francophones and people in remote and rural and remote environments,” says Marsh.

Another approach is to use the test and keep its limitations in mind, says Ian Walker, dean of admissions at the University of Calgary’s school of medicine. “It has shortcomings, but that’s something to keep in mind when you’re evaluating the results,” he says. “You need to say okay, this is your MCAT score. Are you from an aboriginal background, do you come from a demographic group that is known to be disadvantaged by this test?”

The test has also been revised, with the new 2015 version including biochemistry, psychology and sociology, in an attempt to screen for more well-rounded students. It’s too soon to say whether the research on the old test will apply to the new version as well.

Supporting minority groups & looking for diversity

The Association of Faculties of Medicine of Canada has asked schools across the country to focus on increasing the abilities of under-represented groups to enter medical school. A study from the association found that there were significantly fewer black, Filipino and Latino Canadian medical students than are present in the general population – and those with an average family income of over $100,000 were significantly overrepresented. The number of Indigenous students in schools is also a universal focus for improvement, with many schools offering separate entry streams for Indigenous Canadians.

While some schools use quotas, outreach programs designed to increase the likelihood that underrepresented minority students compete successfully also show promise. The University of Toronto offers pre-application support for black students through a program called Community of Support. It includes webinars that show how to develop strengths in an autobiographical sketch, and an opportunity to be linked to the Black Physicians Association of Ontario.

Similarly, this summer the University of Calgary will launch Pathways to Medicine Scholarship, a program geared to low-income students, especially those from rural areas or with Aboriginal ancestry. It provides $21,000 of financial assistance as well as a paid summer internship and mentorship and support from faculty. And the Ontario Medical Students Association also runs a mentorship program called Altitude, which matches first-year medical students with first-year undergraduate students from rural communities or those from lower socioeconomic backgrounds.

In the end, every school has a different approach – which is good, because every faculty is searching for a different kind of student. And “the application process is never going to be perfect,” says Reiter. “Any one tool has limitations. But with at least two different measures of the cognitive, and two of personal characteristics, we can try to triangulate. We don’t want to put all our eggs in one basket.”

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36 comments

  1. Patricia Mirwaldt

    Great discussion of a problem that faces many young Canadians – how to “win the lottery” of medical school admission. The research is not clear, and has been going on for more than 20 years. We still do not have a clear set of attributes that makes the “ideal physician” so why not turn it int an actual lottery, everyone who qualifies by grades or other standards is put into a pool and the school then draws the applicants, this would acknowledge that the students who get in are not measurably better than the candidate next down the list and would offer each qualified candidate an equal chance. This seems more fair and transparent than coaching candidates on how to answer the admissions questions.

  2. Steven Lewis

    Excellent overview of a changing landscape. Let’s go a step farther in the analysis. Health care performance in Canada is, by international standards (Commonwealth Fund surveys, OECD comparisons, etc.) mediocre at best, and woefully substandard at worst. This despite decades of graduating the best and the brightest from our medical schools. Individual physician characteristics and abilities seem to explain little of the variance in system performance. So perhaps the question is less, what makes a good doctor – and I certainly support the changing concepts outlined in the article – but what makes a good system. It doesn’t take a genius to do 98% of what health care does; most is not advanced detective work or extraordinarily delicate surgery, but the everyday work of chronic disease management and the ability to coach patients to look after themselves better. If the system remains designed to promote a fragmented piecework approach to care, and if we do not reverse the hyper-specialization that is both remarkable and a major risk factor for patients, the talent of clinicians will be overwhelmed by an environment that is inhospitable to excellence. Hence it makes perfect sense to select for future doctors who are comfortable with interdependence, teamwork, and data-driven improvement, and who view their mission as doing less for people and more with people who do more for themselves.

  3. Elizabeth Rankin

    GREAT ARTICLE!

    Has anyone considered having a panel of patients as advisors to a medical student selection committee?
    Everyone is a patient at some point but those who are seasoned have likely some ability to make suggestions that focus on the quality side of choosing a doctor, if only they were so fortunate.
    Steven Lewis, who has also contributed to this article raises a key point: the health care system…needs a prescription! To improve the system takes an overhaul, something no aspiring medical student or current health care professional is able to change.
    Patients have a voice…let them participate!

    Elizabeth Rankin

  4. Avi Gross

    The whole admissions thing is BS. Reducing the only objective measures of achievement – GPA and MCAT – to mere components of an application subverts the merit-based standards on which admissions were once based. I’m glad I was accepted before daddy-paid “humanitarian” tourism adventures became the new standard; otherwise I’d be out of luck.

    Hasn’t it been postulated or otherwise well-supported that the lack of human element found in some physicians is directly the result of their inhumane training? Even with the focus on more “humanistic” qualities for admissions, the grinder of medical school and residency removes all of that and replaces it with old-fashioned cynicism. Admissions ain’t gonna fix that. You gotta look at the curriculum.

    Residency selection is even bigger BS. Any semblance of objective achievement in medical school is thrust out the window (its all pass/fail), with success or PERMANENT FAILURE to secure a residency position in a field of the student’s choosing dependent on asskissing (but not too much so that it becomes obvious) during electives – made much easier if you can relate with your staff about those times on the lake with the yacht – and publishing low-impact case reports. At least in the USA they have the USMLE – an essential, very difficult standardized exam – to set people apart.

    Not to mention that our very own Canadian students are PROHIBITED from applying to select residency positions in such wanting fields as UROLOGY that the government has decided are the exclusive right for International Medical Graduates. Guess its nice to have a lobby of wealthy parents to push for positions in such underserved areas like Toronto and Ottawa. Meanwhile the kids from Kenora or Fort St John who hit the bricks the old-fashioned way have to take scraps.

    So we wax sanctimonious about the difficulty and importance in admitting those physicians that are just so humanly with their Africa trips and their sports medals. Why don’t we give credit for students that manage to keep a high GPA while holding an actual job to pay for their damned educations?

    Each class has their token few working-class proletariats, all expected to be rural family doctors, because those wealthy specialists’ kids just aren’t interested in being rural docs. They need the “culture” of the city and the “educational opportunities” for their kids. The blood become a mix of clot and steam.

    • TC

      Wow….the harsh truth! It needed to be said…. and you did it bluntly. I agree…. a well rounded individual who is empathetic & hard working might be that person who kept their grades up, paid for school, and held down a crappy retail job. Not likely to be the ones who had the luxury to “volunteer” over their summers off. The residency selections process is severely biased to those with connections, not the blue-collar kids or aboriginal grads. Life experience counts, but how do we measure what that is?

    • Mama Bear

      Thank you for the Truth. Well said. My daughter worked her very hard to get top grades 97% in honars and AP classes. And worked her butt off on the field to get a soccrr scholarship to pay for school. And now shes told she needs to do humanitarian work…..REALLY!!#!

  5. Carole Lafreniere

    What about making it easier to come back for the more than 3,000 Canadians who decide to go study medicine abroad? These IMG Canadians don’t have their studies subsidized like other Canadian medical students. Studying abroad easily costs more than double abroad than what it costs in Canada. At this time, anyone wanting to apply for residency in Canada has to do 3 exams on top of the ones they are doing in the U.S., the U.K. or Australia….and that’s not knowing whether or not they will even be accepted in a Canadian residency program. To take these 3 additional exams, you almost need to factor in another semester of time and expenses to get ready. Anyone ready to compensate these students for the extra time and money spent for Canadian residency? If not, then don’t be surprised if Canada continues experiencing a “brain drain” to other countries. You would think that if these Canadian IMGs are good enough for the U.S., the U.K. and Australia, they should also be good enough for our Canadian system. And who says that they aren’t better than some of our Canadian medical students? In fact I would argue that being exposed to other medical systems would make them pretty interesting candidates to help the Canadian system find solutions to some of its problems.

    • Dorthe

      I would argue that diversity in medical school should include socioeconomic diversity, so that our physicians in Canada come from diverse socioeconomic backgrounds.

      There isn’t enough solid data on this, but I would LOVE to see a study on parental income of the many Canadian students that study medicine abroad. I would argue that their average SES background has much more privilege than the already wealthy background of medical students in Canada. They have to put up 300K up front into an escrow account to prove that they have the financial means to pay for all 4-6 years. Most of my friends who have taken that route had their parents pay for this.

      Yes they have exposure to other medical systems, but those foreign programs also cater towards a North American curriculum and they’ve created the spot for profit.

      • Dr Mad

        Its no secret that the kids that go abroad mostly have rich parents.

        I’ll admit I am very bitter about this. I come from a poor family, and worked very hard to prove myself enough to obtain admission into a Canadian medical school.

        Meanwhile, these rich kids who couldn’t cut mustard in university have mommy and daddy pay for their MDs in Ireland or the Caribbean. Ok, so they go abroad and that’s their choice, what’s to be so worked up about right?

        How about the fact that these jet-set undergrad slackers who got their parents to buy them an opportunity the rest of us worked our asses off for have residency positions in COMPETITIVE fields in COMPETITIVE locations SAVED for them. This means a medical student from Canada CANNOT apply to them even if they are more qualified.

        If that’s not the product of corruption and a collective effort of the parents of these slackers “pulling the strings” to get their spawn up to the stratosphere with them, then I don’t know what else to say.

        • Dr Mad

          I will also say that I resent the term CSA (Canadian Studying Abroad). This term is used to somehow differentiate students who are Canadian citizens studying at off-shore for-profit schools vs foreign-trained physicians from other usually impoverished and corrupt countries, as if the Canadian citizens are somehow owed residency positions and jobs here vs their foreign-trained counterparts, who are called International Medical Graduates, or IMGs.

          Given the above CSA is a discriminatory term that attempts to differentiate physicians not on their training but on their countries of citizenship, as if the Canadian citizen who trained in Ireland is somehow more worthy of practicing in Canada than the permanent resident from India, or England, or South Africa, merely because they are Canadian citizens. That’s ludicrous.

          We should not muddy the waters. If a physician obtains an MD or comparable degree at a medical school that has not been accredited by the LCME, then that person is an International Medical Graduate (IMG).

          • K

            Well said, Dr Mad. I totally agree with you!

          • MJG

            I agree that a quite a few of the IMGs are spoiled brats; there will always be a few bad apples in the bunch. If you look at the statistics of Caribbean/Irish medical schools, the Canadians entering those schools have an avg GPA of >3.5, which is not a bad GPA. Additionally, if you look at USMLE stats, these ‘rich kids who couldn’t cut mustard in university’ attain above national average percentile scores (mind you USMLE is not a joke exam, like the pass/fail ones we take in medschool).

            As a Canadian MD, I can understand your frustration. I worked hard to get to where I am, but that doesn’t make someone with an honors science degree who couldn’t get into one of the 11 Canadian medschool a moron. They couldn’t get in, but atleast they stuck to their dreams, worked hard and cleared all the licensing exams. Technically this makes them as good a doctor as any Canadian grad. I think they paid enough penance for some stupid decisions made in their early adulthood.

            You and me both know that being a genius is not a prerequisite to complete medical school, any average undergrad with a GPA of >3.5 can easily complete medical school. The problem is, there are few seats and a lot of students desire to be a doctor. Its a supply vs demand thing.

            Anyways, your comments sir has strong undertones of entitlement, selfishness and superiority complex, which I must say is what Canadian medical schools are trying to weed out.

            Well what to do, some people slip under the rug! Kudos mate on getting into medschool! Your ‘hard work’ paid off! Your mom and dad should be very proud!

            PS: Kindly think about Pathology as a residency choice, I don’t think people skills are your forte.

          • MJG

            Well what I meant to say is that, the problem of CSA and IMG and CMG does not have an easy solution, and generalization leads to more harm than good.

            I strongly believe there should be an OBJECTIVE standard for residency selection, which basically puts CSA, IMG and CMG in a LEVEL PLAYING FIELD. The CMGs are supposedly smarter, they shouldn’t have a problem outwitting the spoiled CSAs/IMGs, which means that they won’t have any issue in securing a good residency position. I strongly believe that residencies should be given to you based on your skills/knowledge (like the USMLE) and not based on which school you went, or how smart you were four years ago.
            “I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin, but by the content of their character.” KingJr
            (this is not as discriminatory as color of the skin, obviously exaggerated”

    • HButler@post.Harvard.edu

      Yes, if a country needs more doctors than it can train, pay to send some students abroad: Hybrid vigor! Would you require them to return to Canada?

      We face a doctor-shortage in the U.S.

      H

  6. Ian

    Now if only they would drop the age discrimination….

  7. Melissa B

    Students from families that make an average family income of over $100,000 are overrepresented for a variety of reasons, but a main one has to do with the expenses associated with JUST applying to medical school. It costs thousands of dollars every application cycle, not to mention that most students have to apply more than once. Other costs need to also be taken into account, such as, the MCAT prep courses, the MCAT itself, possibly rewriting the MCAT, CASPer, time off work for interviews, etc. How can ‘diverse’ students even afford to apply?

    I agree with Ian about the age discrimination. As a ‘mature’ student who has been out of school for quite some time, the application process is certainly not ‘mature student’ friendly. I think that mature students have different life experiences and knowledge that can be an asset to the medical field, therefore they cannot be lumped into the same category as someone just graduating from an undergraduate degree.

    Just my thoughts!

  8. Alun Edwards

    As always, Steven Lewis’s analysis is thought-provoking and caused me to pause in my initial reactions to this article. I had, however, come to the same conclusion that the key question is “what makes a good doctor?” or perhaps in taking the system view of things – what does a doctor do? It seems possible that the changes to medical school enrolment might be driving the definition. In saying this I have to disclose coming at this from a ‘hyper-specialist’ view albeit, I hope, tempered by experience, chronic disease management and some commitment to think about system change.

    The issue of reducing scientific prerequisites is the one that struck me as being troublesome. Identifying that those with non-science backgrounds do as well in our medical schools are not impeded in success may well be a reflection of changing curricula which have already de-emphasized the scientific basis of medicine. While the skills of assessing quality of evidence are important, those of problem solving from first principles depend more on foundational knowledge. Steven’s point that the detective work in medicine may be a small component of the doctor’s day (a very rewarding one nonetheless) is well taken though I’m not entirely convinced because, for me, detective work also includes analysis of the reasons patients aren’t doing well in self-management. This combines the need for both humanistic and inquisitive traits in our health care providers. Does science education not predispose to more critical questioning? I’m fairly certain medical qualification examinations don’t test that. How much does this lack of critical thinking influence the frightening need for retroactive initiatives like Choosing Wisely to curb the unthinking over -utilization of precious health resources?
    The blending of roles in the team-based approach to care really does merit serious discussion at medical school admissions committees but diminishing the scientific approach has its perils – though perhaps I’m now confusing curricular issues with admissions. And therein is the rub – defining what a doctor does should determine what the curriculum is. Taking Steven’s system view might well need reconsideration of the entirety of health professional education. I have a suspicion, for example, that some Faculties of Nursing devote more time to science teaching (anatomy, physiology and pharmacology) than some medical schools – is this something that meets nurses roles in chronic disease care/ care of the elderly?

    It’s pretty clear that the traditional constructs of medical school admissions and curricula are dated and inadequate.

  9. HButler@post.Harvard.edu

    “Palmam Ferat Qui Meruit”

    I hope the country to the south of Canada takes a lesson from this article. We are all patients; patients can tell within seconds whether we want to be treated by the doctor who walks into the room.

    H. E. Butler III M.D., F.A.C.S.
    HButler@post.Harvard.edu

    • Disappointed Education

      That’s correct. When sick, people’s instincts and human-interaction perception are higher, more sensitive. Patients don’t feel safe when the Doctor is tired, rushed, impersonal and sometimes even bored…

  10. Daniel Johnson

    It’s not about ‘who makes a good doctor’, it’s about keeping the numbers low to maintain a ‘shortage’ of doctors to keep the profession artificially more profitable than it should be. Our society once had more doctors per capita, allowing doctors to actually know their patients, make house calls, etc, but the profession has worked to keep it’s numbers down, endangering lives and sabotaging our medical system, so they can keep charging more.
    The entire medieval ‘doctor’ paradigm is outmoded, we don’t need ‘doctors’ anymore, we need flesh techs, lots of them, trained at lower cost with no more of this ‘prestigious profession’ bullshit.

    • Disappointed Education

      Perfect comment! You see these overly-stressed, tired, depressed Doctors, and many have no joy in practicing anymore, their personal lives are shattered, and their money get spread out to ex-wives and kids…. Sad, sad, sad….

  11. Ali

    Looks impossible to get into med school.

  12. Jim

    Sadly, it appears the PC drive for diversity trumps intellectual prowess.
    Changes to the traditional academic requirements only enable those schools with social agendas, likely driven by a need to satisfy wealthy benefactors or governments, to pick applicants who are acceptable to those who hold the purse.
    We have too many graduating classes of physicians in Canada that patients may no longer be assured are fully competent, only politically correct.

    • Disappointed Education

      You are absolutely right! I will better get diagnosed by an AI computer/robot than by a politically-correct Doctor.

  13. rajeev

    I am quite puzzled with the process. At this rate, we may soon have diagnostics by software and prescriptions vended by robots. “Medical Artists” could be leading the pack instead of “Doctors of Medicine”. I am not too convinced. I feel medicine is primarily an area of science; and a candidate that can handle the sciences, for sure has the intelligence, smartness, empathy and integrity to look after patients from different walks of life, including people of different color, caste, creed, religion, gender, age, personal habits and addictions, geography, culture, sexual preference, physical attributes, financial health etc.

    • Disappointed Education

      Absolutely agree! Solid scientific background should be the basic rule here! I want my Doctor to be a professional, not an ex-champion in Basketball!

  14. Peter Morris

    There’s something I don’t understand: Admission averages are extremely high, but all Canadian doctors I’ve seen have no idea about what medicine is… They seem to be “guessing” diagnostics! The health system is TERRIBLE! I have to travel back home when I need to see a doctor or a dentist!

    That’ what I don’t understand…

  15. Disappointing Education

    Very interesting article and comments. It’s very disappointing that talented, eager youths are being left out. The system should allow everyone (with Life Sciences prerequisites) in, then weed out based on strict merit and performance, not Rope-Skipping and Choir Singing.
    Before I go see a new Doctor, I check their background. If they have an undergrad in anyhing else but life science-related areas, I don’t trust their practice. A ‘well-rounded’ Doctor should be someone who understands the science of the human body and of disease. Being an undergrad in History or Industrial Engineering then becoming an MD is something I simply cannot understand.
    Anyway, it’s being predicted that soon enough Artificial Intelligence will take over Medicine…and if the Canadian health system struggles so much to raise its Doctors, I will definetely trust a computer/robot!

  16. Alicia

    A step in a better direction for Ontarions and Canada as a whole. As a parent to two very bright and academically gifted children, whom are racalized, and interested in advance studies and medicine; the changes are welcoming.

  17. Ghith

    LOVELY. Became an IMG, because had difficulty in BSc Maths. Now idle, with limited options to specialize. what a disastrous end result. Now reading this, is like a knife in my heart.

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