By Marcia Chaiken and Jan Chaiken—

Several decades ago, we met American students attending the Universidad Autónoma de Guadalajara (UAG) School of Medicine waiting in line at La Chata – an ever-popular restaurant in the city center worth the wait. We chatted as the line inched forward and agreed to be seated together when we reached the front. We were surprised that the students were conversant in Spanish but definitely not fluent and wondered how they were able to understand their med school lectures. They explained that the UAG program was developed primarily for US students, with many courses in English and coordinated with hospitals in the US for clinical rotations. We assumed their decision to attend UAG was motivated by the beauty and rich cultural opportunities in Guadalajara.

Years later, we had closely watched our oldest granddaughter, youngest niece, and cousins’ kids negotiate the lengthy process of applying to US undergraduate schools that have high acceptance rates for med schools, then applying to outstanding med schools, and then seeking a “match” for residency in a specialized field. We frankly wondered if UAG and similar med schools in Mexico would have provided an easier option for aspiring MDs who wanted to practice eventually north of the border.

Medical school acceptance rates in Canada are extremely competitive. There are 18 accredited medical schools in the country – of which 7 are in Ontario. The overall acceptance rate is under 15%. The acceptance rate is even lower for applicants who live out of province – about 5%

While there are about 160 accredited med schools in the US that grant MD degrees, competition is still fierce. Fewer than 50% of applicants are accepted each year: the med school that our granddaughter attended accepts under 3% of applicants each year. At her white-coat ceremony at the beginning of her first year, the dean of students pointed out that all the newly inducted students and many other applicants met the basic criteria for acceptance: very high undergraduate grades, very high Medical College Admission Test (MCAT) scores, and extracurricular activities involving medical proficiency. But the reason they were selected was because all of them demonstrated a very high level of compassion for others.

Mexico, with 151 med schools, has slightly fewer than the US. The acceptance rates vary significantly between the public medical schools and the private ones in Mexico. The highly prestigious public Universidad Nacional Autonoma de Mexico (UNAM) accepts fewer than 2% of medical school applicants. Universidad Autonoma de Nuevo Leon (UANL), which some say is second to UNAM in prestige, is less competitive but still rejects close to 90% of applicants. Some of the top-tier private medical schools with classes in English, such as the Universidad de Monterrey, are equally as competitive. Whereas the private UAG accepts about 43% of applicants, other private universities have developed more inclusive programs leading to medical degrees that are frankly aimed at attracting English-speaking students from north of the border. Anahuac University has such a program in Cancun which accepts about 60% of applicants. Xochicalco School of Medicine has campuses near the US border and accepts over 80% of applicants.

In general, students north of the border who have not been accepted at a medical school of their choice in their home country do have opportunities to study in a medical program in Mexico. But realistically they are highly unlikely to be accepted in one of the most prestigious medical schools in Mexico. Their best chance appears to be one of the programs that have been established to educate students from the US and Canada.

Another barrier to medical education north of the border is cost. In the US by 2024, four years of tuition, fees, and living expenses generally cost between $250,000 and $400,000. Tuition each year alone in US medical schools two years ago cost between $42,000 and $67,000, depending on whether the school was public or private and the region of the country. Tuition in Canada is generally significantly lower for Canadian residents, ranging from $4000 to over $25,000 – but the annual fee for foreign students can reach between $90,000 and $100,000 (Canadian dollars). Tuition in the prestigious public medical schools in Mexico are essentially symbolic and remarkably low for Mexican citizens, for example at UNAM under $30 (US dollars) per year. But foreign students attending the programs in Mexico developed to serve English speakers can expect to pay fees comparable to US medical school tuition – about $36,000 for the first years of in-class basic sciences teaching to $59,000 a year for clinical years spent in Mexico and over $80,000 a year for clinical years with rotations in the US.

Although cost of living in Mexico is reputedly much lower than in the US and Canada, as recent US and Canadian temporary residents can testify, the days when gringos could live high-on-the-hog in Mexico are over. To maintain a standard of living that even the most impoverished American or Canadian med student would expect is no longer inexpensive in Mexico.

Another consideration in choosing a medical school is the probability of matching with a residency program after graduation. For those in their last year of med school “Match Day” may be ranked as high on the anxiety scale as a wedding day. In fact, in the case of our granddaughter, Match Day engendered even more excitement. Imagine, the hundreds of soon-to-be MDs all waiting to be informed at precisely the same second whether they were chosen to be a resident in the field of their choice at a highly desirable teaching hospital, a hospital that was not exactly high on their list – or even any hospital at all.

Before choosing one of the programs in Mexico for a medical education, prospective students must realize that earning an MD degree does not escape the rest of the arduous process of becoming a licensed physician in the US or Canada. Admission to a US or Canadian residency program is not guaranteed and may not even be possible depending on the med school and the particular program of studies undertaken in Mexico. For Canadian graduates of Canadian medical schools, post-MD residency is almost guaranteed – over 95% of applicants “match” within their preferred field. And for graduates of US medical schools, the match rate for US residency programs has been only slightly lower. However, the match rate for residency in the US for students who completed MD degrees out of the country (including in Mexico) is much lower – in 2024 according to the American Medical Association – 67%. And although first-time residency applicants from foreign med schools matched in Canada at a respectable 87%, those who didn’t match during the first application were unlikely to be more successful in subsequent applications, with rates dropping to under 30%.

Finally, to be licensed to practice in the US or Canada, MDs trained in other countries must take a sequence of rigorous exams that require intense study. Most medical school students take some of these exams as they complete their in-class studies and are at the top of their game. And based on our observations of young relatives going through this exam process – one really needs to be passionately committed to practicing medicine north of the border to have the stamina and knowledge to pass.

As much as we love Mexico, we advise young students who have applied to med school in the US or Canada and were not accepted, think twice. Take a year or two and work in a related field. Find out if you really have a passion for medicine, and if you do, choose one of the programs in Mexico that is authorized to make sure their graduates match for residency in the specialty you want in the US or Canada.