What exactly is meant by bottom, top and middle tier schools? I am a Canadian, and no such distinction is made with our med schools. Most of them are of the same quality. What are the disadvantages of going to a bottom tier school? What type of GPA, MCAT scores are expected from top and bottom tier schools? If a student does undergrad medical education at a lower tier school, how hard is it to do grad medical education at higher tier school? Enlighten me, please. Thanks. C.