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Recently, changes to med school admissions in Ontario regarding international students have effectively banned international applicants from studying medicine in their province.
The rest of Canada has not massively changed its medical school admissions guidelines, but we will touch on the current state of things below.
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New Ontario Admission Policy and Ban
Starting Fall 2026, Ontario is effectively banning international students from enrolling in Ontario-based medical schools.
Per a new law passed in 2024, 95% of Ontario med school seats will go to Ontario residents and 5% to other Canadians, meaning non-Canadians will no longer be eligible to attend Ontario medical schools.
Ontario’s goal is to keep more students in-province after graduation to address doctor shortages and healthcare deserts close to home.
Before this major legislative change, international admissions in all of Canada were already limited. Only a handful of non-Canadians were permitted to attend Canadian medical schools each year.
Outside Ontario, there have not been many major policy shifts. Other provinces still allow a few international spots. For example, McGill University’s School of Medicine may offer up to 2 seats to international students out of an average of 57 applicants.
Significant Tuition and Financial Changes
Starting in Fall 2026, Ontario is offering ample tuition coverage for 1,000 Ontario med students who agree to work as family doctors in Ontario after graduation as part of the province’s “Learn and Stay” program.
International students have always paid much higher med school tuition in Canada than Canadian citizens, and that hasn’t changed. Also, U.S. students can find a lot more federal financial aid assistance and scholarships when going to American medical schools, unlike when they go to Canadian medical schools.
Domestic Canadian students pay far less due to provincial subsidies of about $5,000-$25,000 a year per student.
Immigration and Visa Regulations
Compared to previous years, upcoming school years will be more restrictive for international students at the visa stage, not just in Ontario.
These significant changes (detailed below) mark the end of the open-growth era of the 2010s, when there was no cap on study permits, no provincial pre-approval on visas, and an active push for Canadian medical universities to attract students from across the globe.
Note: To attend medical school in Canada, you need both a visa and a permit. The visa allows you to enter the country, and the permit enables you to stay at Canadian universities to study.
Learn More: Med Schools That Accept International Applicants
Study Permits
The federal government has introduced a national cap on international study permits (including Americans).
Canada capped international study permits from 2024 to 2025 to control intake, a 35% decrease from 2023.
Attestation Letters (PALs)
Starting January 2024, Canada’s federal government now requires a Provincial Attestation Letter (PAL), which is a stamp of approval that each applicant will need to get from the provincial government before applying for a student visa (not just med school).
Each province has its own limit on PALs it can give out, outside university control.
Read Next: Best Med Schools for Non-Trad Students
Post-Graduate Changes
International grads pursuing postgraduate training programs may find it easier to get work in Canada going forward, as long as they’re already in Canada studying.
Canada’s immigration stance is gradually becoming more accommodating in terms of staying on as a healthcare worker after studying in Canada, as well as for foreign-trained doctors. Canada’s 2024 budget invested in recognizing international health credentials.
However, the initial permanent residency eligibility requirements remain the same: strict.
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Accreditation for Medical Schools
Since 1993, Canadian MD programs have been co-accredited by the U.S.-based LCME (Liaison Committee on Medical Education) and the CACMS (Committee on Accreditation of Canadian Medical Schools).
Starting July 1, 2025, LCME will no longer co-accredit Canadian schools. Instead, Canadian medical schools will be accredited by CACMS alone.
How These New Changes Will Impact Residency Applicants
Based on this change to accreditation reciprocity, significant changes are coming for postgraduate medical residency applicants. (Note: Don’t confuse medical residency programs with Canadian permanent residency status.)
Before 2026, U.S. grads were treated as domestic applicants in CaRMS (Canadian Resident Matching Service). The special USMG (United States medical graduate) category is disappearing. U.S. grads now count as IMGs in CaRMS.
As a result, Canadian MD grads are now considered IMGs when applying to U.S. residencies, and American MD grads are considered international applicants in Canada for residency application purposes.
However, Ontario, Quebec, and other provinces are gradually increasing IMG slots for post-med school residency programs, which may offset the difficulties of applying to these spots as an IMG. Yes, even Ontario, which has effectively banned international applicants from med school.
Some provinces now accept a limited number of visa trainees (foreign non-permanent resident graduates) with return-of-service agreements — as in, you agree to practice medicine in the province after you complete medical residency, and they’ll make it easier for you to get a visa.
Still, most IMG residency positions require Canadian citizenship or permanent residency.
U.S. medical school graduates must now meet full IMG requirements in Canada to apply for a residency position, including:
- MCCQE Part I
- NAC exam
- Competing for limited IMG-designated residency spots
- Temporary Resident Visa (TRV)
- Study permit
- ECFMG certification
The same is also true for Canadian medical school graduates who wish to apply for residency in The Match. Like all other IMGs, Canadian MD grads must now get ECFMG certification to apply for USA residencies.
What All of This Means for U.S. Applicants
Before 2026, U.S. applicants had more Canadian medical school options and often received special consideration in CaRMS (medical residencies).
Starting in Fall 2026, fewer med schools in Canada will accept U.S. applicants since Ontario is virtually closed to international applicants.
The residency pathway is harder, too. U.S. med school grads are now treated as IMGs (international medical graduates). Before recent changes, U.S. and Canada residency programs were accredited reciprocally, and students from one country could apply to a residency in the other without the additional hoops of an IMG. Now they’re accredited separately, and the pathway is similar to any IMG’s.
There’s more red tape, but there are resources to make your med school dreams come true.
Read More: The Easiest 30 U.S. Med Schools to Get Into
FAQs
If you are currently an enrolled international student at an Ontario medical school, you should be able to return to school, even after the Fall 2026 restrictions take place. These rules seem to only apply to first-year seats.
Not only is recent legislation restricting international students from applying to med school in Canada, but certain schools have made it even more competitive for international applicants by softening prerequisites for domestic applicants.
For example, Memorial University of Newfoundland Faculty of Medicine and Dalhousie University Faculty of Medicine are accommodating Canadian applicants with lower GPAs and MCAT scores to encourage local pre-medical students to stay local.
Are there any Canadian med schools outside of Ontario that will still accept international students?
Yes, although Ontario is effectively banning international medical school applicants, other Canadian provinces still allow international applicants. Below are some Canadian med schools that still accept international students:
- McGill University
- Dalhousie University
- Memorial University of Newfoundland
- University of British Columbia
- University of Alberta
- University of Calgary
The following universities with medical programs require French proficiency but do not require the MCAT:
- Université de Montréal
- Université Laval
- Université de Sherbrooke
Below are the medical schools in Ontario, all of which will reserve 100% of their seats for Canadian residents (mainly Ontario residents) starting in Fall 2026:
- University of Toronto
- Western University
- Queen's University
- University of Ottawa
- Northern Ontario School of Medicine
- McMaster University’s Michael G. DeGroote School of Medicine
- Toronto Metropolitan University (opening Fall 2025)
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Sahil Mehta MD
Dr. Mehta is the founder of MedSchoolCoach and has guided thousands of successful medical school applicants. He is also a practicing physician in Boston where he specializes in vascular and interventional radiology.
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