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Med school in those countries tends to last a year or 2 longer.

Also most other countries have national education programs for secondary school. High school in the US is regulated at the state and local level, so it’s very variable. As a consequence, the first 2 years of college tends towards general and education.

Another note, there’s also a med school entrance exam in the US.

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Sure but in the US it is 4 (undergrad) + 4 (med school) so in total it is 8 years rather than 5 or 6.

Agreed regarding the US high school standards but students that take AP courses in high school can take the MCAT. They may not do the “best” but they will know some of the material. Schools in the US like UMKC have 6 year programs were high school students take the MCAT.

In a lot of ways, the first two years of US undergrad are "remedial high school". This also explains how, e.g. American undergrads typically declare their majors until mid to late into their second years.

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