When we started medical school, we knew we were taking on debt. What we did not fully appreciate was how differently that number lands depending on where you study, how you funded it, and what happens to the balance in the years between graduation and your first real paycheque.
Most people have a vague sense that medical school is expensive. But the specific numbers matter, because they shape decisions you will make for the next fifteen years. And most of the debt figures that circulate online are American, which makes them close to useless if you are Canadian.
Here is what the picture actually looks like.
The Canadian Baseline
For students at Canadian medical schools, debt at graduation is largely tuition plus four years of living costs, minus whatever family support or savings you brought with you.
Canadian tuition varies substantially by province. The Association of Faculties of Medicine of Canada publishes the tuition and fee data that most Canadian debt figures ultimately trace back to, and it is the source worth checking rather than any given blog, including this one. [1] Ontario schools sit at the higher end. Quebec residents at Quebec schools pay dramatically less. That spread alone can mean a six-figure difference across a full degree.
The other structural difference from the US is how Canadians borrow. Most Canadian medical students fund the degree through a professional student line of credit from a major bank rather than through government loans. Those lines currently run up to around $400,000 for medical students, with roughly $100,000 accessible in first year, interest-only payments during school and residency, and no principal due until well after training ends. [2][3]
That structure is genuinely favourable compared to the American system. It is also, quietly, why a lot of Canadian medical students end up owing more than they planned to. A loan gives you a fixed amount. A line of credit gives you permission.
Studying Abroad Changes the Shape of the Number
If you are a Canadian studying medicine outside Canada, almost none of the above applies cleanly.
Non-EU tuition at Irish medical schools currently runs in the region of €55,000 to €61,000 per year, with the Royal College of Surgeons in Ireland quoting €61,000 for non-EU entry in 2026/27. Across a five or six year programme, that is roughly €300,000 to €370,000 in tuition alone, before rent, flights, insurance or exams. [4] Converted to Canadian dollars, the tuition line by itself lands above what many Canadian-trained graduates owe in total.
Then there are the differences that are less obvious from the outside.
Canadian banks treat students at non-Canadian schools differently. The major lenders advertise no co-signer requirements for students at Canadian institutions and are considerably less generous about schools elsewhere. [3] We wrote separately about whether a Canadian bank will lend to you at a school outside Canada, because it is the most-asked money question among Canadians going abroad and the published answers are vague.
Federal student aid changed this year as well. As of 1 August 2026, students attending private, for-profit international institutions are no longer eligible for Canada Student Grants and Loans, with a transitional provision for continuing students to 31 July 2029. [5] That does not affect every Canadian abroad and it does not mean what a lot of people online are saying it means, but if you are budgeting a degree abroad it belongs in the calculation.
And there is the part that never appears in a tuition table: what a medical degree abroad actually costs once you add flights home, health insurance, immigration registration, elective travel, and exam fees for two licensing systems instead of one.
What Happens During Residency
Here is the part that catches people off guard regardless of where they trained.
The debt does not pause when you graduate. Interest continues to accrue throughout residency. On a Canadian professional line of credit you are typically making interest-only payments during training, which means the balance does not grow, but it does not shrink either. [2] Five years into a surgical residency you can be exactly where you started, minus five years of your life.
Resident salaries in Canada are set by provincial agreements and begin in the range of the mid-fifties to low sixties in the first postgraduate year, rising each year. On that income, in a city like Toronto or Vancouver, aggressive repayment is not usually realistic. Most residents cover interest, live, and wait.
That is not a failure. It is how the structure works. But it means that if you graduate owing $300,000 you should expect to owe something close to $300,000 on the day you finish residency, and to begin repayment in earnest somewhere in your early thirties. Understanding the full financial timeline before you are in it is worth more than any single repayment tactic.
How Long It Takes to Clear
The honest answer is that it depends almost entirely on what you do in the first three years as a staff physician.
Physicians who attack the balance immediately after training, before spending adjusts upward to match the new income, routinely clear a large line of credit in under five years. Physicians who buy the house and the car first often carry it into their forties. The income is high enough that both outcomes are possible, which is exactly why the decision matters.
There is no Canadian equivalent of the American PSLF programme, so waiting is not a strategy. There are provincial return-of-service arrangements that include loan forgiveness in exchange for practising in underserved areas, and those are worth knowing about, particularly for international medical graduates, for whom return-of-service commitments are frequently attached to residency positions in the first place.
What This Means for You
A few things stand out to us.
First, the number that matters is not the average. It is yours. Averages blur together a student who paid Quebec tuition and lived at home with a student who paid non-EU international fees and rented in Dublin. The gap between those two people at graduation can be a quarter of a million dollars. Sit down once and estimate your own total rather than reading someone else’s.
Second, a line of credit is not free money and it is very easy to treat it as though it is. The most useful habit we have found is checking the balance monthly. Not because you can do much about it, but because seeing the number stops it from becoming abstract. The habits that make a disbursement stretch matter more when the money is borrowed than when it is earned.
Third, the decisions that actually move this number are made early. Where you study, how much you borrow in first year, and whether you cover interest during training will affect the total far more than any optimisation attempted later.
We are still in training ourselves, so we are not going to tell you what to do with your own borrowing. But knowing the shape of the number, rather than avoiding it, makes the whole thing considerably less frightening.
The Bottom Line
Canadian medical students typically graduate owing somewhere in the low-to-mid six figures, funded mostly through professional lines of credit rather than government loans. Canadians who study abroad usually owe more, sometimes substantially more, because tuition is higher and borrowing options are narrower.
That balance will not shrink during residency, and repayment realistically begins once you are a staff physician. None of that makes medicine a bad financial decision. It just means the plan should start before the debt does.
If you are working out your own numbers, the AFMC data and your own school’s official figures are the places to start. We keep a list of the sources we actually trust on our Resources page.
References
- Association of Faculties of Medicine of Canada. (2026). Tuition and student debt data. https://www.afmc.ca/
- Scotiabank Healthcare+. (2026). Banking for medical students. https://www.scotiabank.com/ca/en/healthcare-plus/physician-banking/medical-students.html
- TD. (2026). Medical, dental and veterinary student line of credit. https://www.td.com/ca/en/personal-banking/products/borrowing/lines-of-credit/medical-dental-veterinary-student-line-of-credit
- College Council. (2026, June 17). Study medicine in Ireland: fees and entry. https://college-council.com/en/blog/study-medicine-in-ireland
- Government of Canada. (2026, June 12). Canada Student Grants and Loans. https://www.canada.ca/en/services/benefits/education/student-aid/grants-loans.html