So, you want to be a doctor?

If you want to significantly increase your odds of making it into medical school, choose your place of birth wisely. Or at least move to the province where you want to go to med school, long before you apply. Surprise: most med schools overwhelmingly favour applicants from their own province, reserving almost all of their seats for locals. In virtually every other field, universities promote geographic diversity. Thanks to pressure from provincial governments, Canadian medical schools are a whole other story. “We don’t have the academic freedom to just pick the best applicants [regardless of geography],” says Dr. Evelyn Sutton, assistant dean of admissions and student affairs at Dalhousie University.

The only medical school in Manitoba, at the University of Manitoba, reserves 90 per cent of its seats for Manitobans. Last year at Dalhousie—the only med school in the Maritimes—81 out of 90 seats were assigned to Maritimers. At the University of British Columbia, the province’s only med school, only four per cent of seats are open to out-of-province applicants. Hoping to go to medical school in Canada? You may not be able to roam far from home.

The big exception: Ontario. The University of Toronto, the University of Western Ontario, Queen’s, and Northern Ontario Medical School all say that they do not place limits on out-of-province applicants. So if you’re from Manitoba, Saskatchewan, the Maritimes or B.C.—each of which has only one medical school—you’re in luck: you have more than one med school option. And if you’re from Ontario, well, you’re going to be facing a lot of competition.

But years before you sit down and fill out a medical school application, even before most kids have their driver’s licences, you have to start planning for med school. An essential step to be taken as early as middle school? Stick with those science and math courses. “If you want to keep medicine open, [take] at least a few sciences throughout high school,” says Sutton.

Most medical schools will consider applicants with an undergraduate degree in any discipline, including non-science degrees. Having a full course load—and high marks—is more important than any particular degree. But what you studied prior to university, way back in high school and junior high, is going to matter because of four simple letters: MCAT. The Medical College Admission Test is an exam that’s designed to assess problem solving, critical thinking, writing skills—and scientific knowledge. “Even if someone has a music degree,” says Sutton, “they have to show they have an aptitude for sciences.”

The MCAT is one way that most med schools check for scientific aptitude. Nearly every medical school in North America requires it. How would an applicant without a strong science background fare on the MCAT? According to Dr. Joyce Pickering, associate dean of medical education and student affairs at McGill University, “they would probably have trouble on some of the sections.” Even though various undergrad science courses may not be prerequisites at your preferred medical school, university-level science is a kind of stealth prerequisite, essential to scoring well on the physical and biological science portions of the MCAT. And you can’t take university-level biology, chemistry and physics unless you take high school biology, chemistry and physics. And that means taking Grade 7 and 8 math and science.

Your university grades will also matter. A lot. At Queen’s University, for example, the admissions committee uses undergrad grade point averages to help decide who gets called in for an interview. But at Queen’s—like many schools—a high GPA is no guarantee. Once at the interview, applicants can no longer hide behind their high test scores.