For Harold Reiter the tipping point was the entering class of 2002.
As the new chair of admissions at McMaster University's medical school, he took one look at the proportion of women admitted - a whopping 76.9 per cent - and wondered what had happened to the men.
The gender gap at the university's Michael G. DeGroote School of Medicine was one of the widest in the country and one of the factors that prompted Dr. Reiter to rethink the admissions criteria.
"It was those very numbers that made me start to look at the breakdown of the applicant pool, in terms of the ratio of male to female, and the discovery of what was, I think, an over-emphasis on grade point average," he said.
Basing admissions mostly on marks, it seemed, had contributed to the decline of men's numbers in medical schools. Dr. Reiter, who was new to the position, decided the school should put less emphasis on marks and broaden its requirements, which eventually it did. The proportion of men has since slightly increased.
Dr. Reiter's candour is rare. Admissions officials are uncomfortable acknowledging that they are even troubled by the lack of men in medical school. During the past decade, men's interest in medicine has hardly budged, while women have been drawn to doctoring in ever higher numbers - a trend many regard as yet another sign of males slipping in the sphere of academics. The imbalance is greatest in Quebec, where women make up more than 70 per cent of students at francophone medical schools.
Medicine has been flagged as a field where the gender imbalance could lead to a shortfall of labour - just as an aging population increases demand. Research shows that female doctors are more inclined to work part-time than their male colleagues, and avoid certain specialties, such as surgery, as they balance demands of raising a family.
Nick Busing, president of the Association of Medical Faculties of Canada, says "this is a major debate, about getting the right balance of men and women in medicine."
Asked to explain the sudden 20-percentage-point jump in male students admitted to the University of Calgary's medical school between 2004 and 2005, for instance, Dr. Ian Walker, director of undergraduate admissions, was dismissive.
Dr. Walker said the fluctuations were random. "We had no concerted gender factor in our admissions process whatsoever," he said. "That is just a statistical blip."
However, according to Paul Cappon, McMaster is not the only university that has done something about the gender gap.
Dr. Cappon, president and CEO of the Canadian Council on Learning, says that for the past five to eight years, some universities across the country have been tinkering with admissions to boost the number of men in medical school - looking beyond marks to give male applicants, in particular, credit for things like community service.
He predicted no one would say it was going on.
