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Should I consider med schools in Europe?
I remember the conversation clearly: “I am leaving McMaster at the end of the year,” said Patrick, a friend from a student government society where we both represented the first year student body. “What? Why?” I was perplexed. “I am going to medical school in Ireland,” he replied. “What? Why?” I was still perplexed. This was in 2004 and I didn’t even know medical school in Ireland was a thing. And I was surprised that a friend would abandon his degree in Canada to start fresh in what I later learned is a completely different medical training context. He left Canada, went to medical school in Ireland and I am honestly not sure where he is now. However, I have about a half dozen other friends who did the same – usually after a degree or two in Canada – and are now practicing happily in the US and Canada.
I also sadly know that Canadian medical students trained in Poland have a bumpy road when it comes to transitioning between the two systems. After five years of medical school in Poland, many students haven’t seen patients on their own. The medical hierarchy is very rigid and clinical independence is not valued. In this case, the leap to residency is a very hard one.
This month, we are launching a series of posts that explore common questions around medical schools in non-traditional locations: Caribbean, Ireland & Europe, Australia, New Zealand and a few more far flung locales. You can see the first post on studying medicine in the Caribbean here. Getting into medical school in North America is difficult, especially Canada. Getting into medical schools in other places is typically less difficult and there are more spots. So why not take the leap towards a medical degree outside of your native land?
Today, we focus on European medical schools, including those in Ireland, Scotland and Poland. As a region, Europe is one of top three most common foreign medical school destinations for Canadian and US students. Ireland is the most common single country destination in Europe for Canadian medical students.
What are European medical schools like?
The structure of the programs is the glaring difference between European and Caribbean medical schools. The Caribbean ones follow a traditional North American four-year MD structure after a qualifying undergraduate degree – something the Europeans call a two-cycle model - and the European ones do not. Most European countries select their own doctor trainees right from high school. Medical school lasts six or seven years. The first two years are basic sciences and then the subsequent years involve increasing clinical responsibilities.
The Irish medical schools offer credit to students with a completed undergraduate degree. These students are considered Non-EU Medicine Graduates (GEM) at the Royal College of Surgeons in Ireland (RCSI). Canadian students who would like to enter RCSI after high school, are considered School Leavers and their program will take five or six years. For Canadians, the six-year option is the only one available. For Americans, the five-year option is for high school students who have taken enough advanced placement (AP) courses and the six-year option is for those who have not. Canadians and Americans with undergraduate degrees CANNOT use their high school marks to apply to RCSI and must apply to the Non-EU GEM stream. At Trinity College, Dublin, the five-year program is the only one available to non-EU applicants.
In both the five and six year versions, the first two years are foundational in biomedical sciences. After that, the years are spent in clinical placements. There is time for electives and most US and Canadian students spend this time back in North America building their resumes and reputations at schools where they would like to become residents one day.
In Poland, things are essentially the same, and there is a high school and an undergraduate admission stream for non-EU applicants. They have a similar foundational curriculum which is built upon by clinical rotations, including US- and Canada-electives. As I said, the Polish schools have a reputation for limited patient-learner application. The program is delivered in English and it seems to be particularly popular for Polish-speaking Canadians whose parents or grandparents are Polish immigrants to Canada.
A unique program that I think we should discuss here is the Scottish-Canadian Medical Programme, which is a collaboration between The University of Edinburgh and The University of Alberta but takes place at the University of St. Andrews. The program grants an MC ChB degree and a BSc (Honours) to a small group of Canadian medical students after a six-year training process. All six years are spent in Scotland. Masters studies are also available. Canadians can also apply to St. Andrew’s University of Edinburgh Programme at Manchester and compete with all other international applicants. Clinical placements take place in the UK and abroad, as per the students’ preferences.
Are European medical schools legitimate?
The Jagiellonian in Poland writes that they offer, “English-language MD degree programs that stand in compliance with Polish, European Union and North American standards. Graduates of these programs receive MD degrees approved internationally.” They are accredited in Poland and recognized by the US Department of Education and the Medical Board of California. The MD granted by Jagiellonian renders students eligible for the residency match as per participation guidelines for International Medical Graduates (IMG).
The RCSI and Trinity grant MB MCh BAO degrees, which encompass medicine, surgery and obstetrics. They are legitimately recognized and accredited degrees in Europe, which is a significant advantage in terms of legitimacy. As above, St. Andrew’s grants McChB degrees, and all of the above are MD equivalents.
What are the admission criteria?
The admission requirements are less rigorous than in Canada but about even with the United States. Our blog about United Kingdom medical schools has a list of all schools in the United Kingdom including their acceptance rates and average accepted entrance exam scores.
Unlike the Caribbean, there are cut-offs for some of these schools but the schools like to look directly at the transcripts to ascertain whether or not the candidate would work out at their school. They talk about First Class and Second Class Honours in degree programs and percentage scores in high school performance.
How much do they cost?
European medical schools aren’t for profit but they do appreciate that they can charge international students much higher tuition to supplement the schools’ budgets. This happens with all universities in the Western world in some program or another.
The prices vary annually. But the cheapest school is the Jagiellonian at 11,200 Euros per year. The Irish medical schools are about as expensive as the Caribbean ones and students should expect debt loads in the region of $300,000 once travelling is considered.
The major banks on occasion issue lines of credit to students studying in Europe for medical school. Please explore your region to get specific guidance on this.
Where do I actually do my clinical placements?
To be competitive for US and Canadian residency programs, most of your clerkship placements and electives need to be done in the US or Canada. My friends who trained in Ireland did placements all over North America, including Canada. These were crucial. They can be hard to get if you don’t know anyone.
Will I get a residency spot?
The graduates of the European schools are eligible for participation in the U.S. National Resident Matching Program (NRMP) and the Canadian Residency Matching Service (CaRMS). In the CaRMS match, foreign-trained and foreign-born medical school graduates participate in the second round of the match where there are fewer spots in fewer specialties.
We have shared some thoughts on this question generally in our blog post about medical school in the Caribbean.
The Jagiellonian published its residency match results and 26 people matched to North American residencies. They allow 40 students per class and five did not apply this year. However, this doesn’t mean that “Jag” has a 74% match rate because we don’t know how many students from the year before participated in the match. Also, Jag didn’t publish results from 2013, 2014 or 2016 which makes us suspicious.
What about visas?
Schools will help students apply for European visas for studying. However, getting a US visa to study as a medical resident can be tricky for Canadians who match to the US. Yet, residency programs can help with that too. US students who match to the US obviously have no problem. According to the American Medical Association, “IMGs who seek entry into US programs of Graduate Medical Education (GME) must obtain a visa that permits clinical training to provide medical services.”. The most common one is the J-1 Exchange Visitor Program and Educational Commission on Foreign Medical Graduates (ECFMG) Sponsorship. All participants under this category then need to return to their home country for two years after they finish residency or get a waiver by finding a job in the inner-city or demonstrating that they will face persecution if they return home.
So what is the bottom line?
If you go to medical school in Europe, you are not guaranteed a residency spot in the US or Canada. The chances are better for the US but quite unfavourable for Canada. There is a general sense that European and Australian medical school graduates do better than Caribbean graduates in the match.
For the most centralized data available on the issue of studying medicine abroad, see this report from CaRMS on Canadians Studying Medicine Abroad.
About the author:
Dr. Ashley Faye White is currently a rural medicine resident at McMaster University and a senior admissions expert at BeMo. She has an M.D. from McMaster medical school and has navigated her way into med school as a non-traditional applicant.
To your success,
Your friends at BeMo
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