Imagine this scenario: a medical school applicant works hard to earn a competitive GPA and a high MCAT score; they submit their primary application on the opening date and submit their secondaries within two weeks of receiving the prompts; they do well at their interview and are told to expect a decision within a few weeks. But when that email comes, it doesn’t feel like a decision at all. They’ve been waitlisted.
Unfortunately, many med school applicants don’t have to imagine this scenario, because being waitlisted is an all-too-common outcome. If you’re one of these people, you have my sympathy. Being placed on a waitlist (or a “hold,” as some programs call it) can be one of the most frustrating parts of the medical school application process. After all, you’ve done everything you thought you needed to do. Waitlisted applicants often begin to wonder, “What does it all mean? What should I do? And when, oh when, will it end?”
I’m neither a doctor nor a crystal-ball gazer, but I can help decode what it means to be waitlisted. And having seen some of the unfortunate blunders applicants make while on waitlists, I can share what works and what doesn’t.
Knowing what doesn’t work is as important as knowing what does. Both are discussed here, but the springboard for that discussion will be the mistakes – the real mistakes that real, and really intelligent, people make when waitlisted at leading medical programs around the world.
But before I dive into discussing these common mistakes, let’s identify which category the school that waitlisted you falls into.
The three kinds of waitlisting schools
Medical schools fall into three broad categories in terms of how they handle waitlisted applicants. Because schools change policies and might fit into different categories in different years, it is better to focus on the categories, which are constant, than on specific schools, which can change categories from year to year and occasionally even within the span of an application cycle. If you’re not sure which category your waitlisting school falls into, contact the admissions office and ask.
Group 1: Don’t call us; we’ll call you (DCU).
These medical schools strongly discourage any kind of contact from waitlisted applicants. The only thing they want to know is whether or not you want to remain on the waitlist. They’re not interested in updates (at least not from you). They don’t want to sit and chat with you. Leave them alone, they say, because they disregard waitlist communication. USC Keck, UCLA, the University of Washington, the University of Arizona, and the Rosalind Franklin University of Medicine and Science are a few of the medical schools that fall into this category for the 2024-2025 admissions cycle.
Group 2: Show me you love me (SMULM).
Many schools fall into this category. These schools want you to keep in touch and demonstrate your interest in the program while providing them with information that adds to their knowledge of you. For instance, according to the Association of American Medical Colleges, waitlisted applicants to Rush Medical College “are encouraged to upload updates to the applicant portal throughout the cycle.” Washington University in St. Louis and Loyola Stritch also belong to this group as of October 2024. Other schools, including UC San Francisco, Stanford, and the Mayo Clinic College of Medicine and Science, want update letters only after the applicant has been interviewed. At that point, Mayo says, “We encourage applicants to stay in touch by uploading update letters into the admissions portal. Our committee members enjoy reading these updates!”
Obviously, not even a school that wants to be courted likes a pest, so even if a school says it accepts updates, don’t call daily, waste the adcom’s time with long-winded missives, or take any other action that would cause them to question your judgment or sanity.
Group 3: Coy (COY)
These are the schools that say they don’t want to be bothered, like the schools in Category 1, but they actually do want to know about major developments or are open to hearing from you on a limited basis. They are a little mealymouthed when saying, “Don’t call us,” but they certainly are less welcoming than the SMULM schools. Some, such as Geisinger Commonwealth and Harvard Medical School, limit applicants to a maximum of two updates; Albany Medical College accepts only updated transcripts; and others, such as Case Western Research University and Eastern Virginia Medical School, welcome letters from applicants after they’ve been waitlisted, but not before.
Make sure you know what your waitlisting school wants – and doesn’t want.
For the rest of this post, I will refer to the different categories of schools by the acronyms introduced.
Now, on to the mistakes.
Nine medical school waitlist mistakes
- Ignoring the instructions you receive from the school
- Failing to assess or act on weaknesses in your candidacy
- Being modest about recent achievements
- Hiding your genuine interest in the school and your fit with the school’s culture
- Not seeking expressions of support
- Planning a one-time deluge of correspondence… followed by deafening silence
- Complaining to the school about the agony of being waitlisted
- Providing hyperbolic apologies for weaknesses or mistakes
- Playing “hard to get”
Mistake #1: Ignoring the instructions you receive from the school
The waitlist letter says that the adcom needs to know within ten days whether you wish to remain on the waitlist. You leave for a month-long vacation and don’t reply until you get back.
Or the waitlist letter says they don’t want to hear from you. You start calling the admissions office once a week.
You might as well send the school a balloon filled with confetti that says, “I do not follow instructions!”
Right move: Follow the directions in the school’s correspondence that informs you that you’ve been waitlisted. If the school says, “Jump!” you should ask, “How high?”
School instructions generally fall into two categories:
- Contact with the school while on the waitlist
- Discussion of weaknesses in your profile
Whatever your waitlisting school’s instructions are, you should follow them meticulously. This is easy if your school is a DCU or SMULM school. If they say to contact the waitlist manager, contact them! Find out whether there is anything you can do to improve your chances of moving from the waitlist to the accepted list. Ask about the waitlist procedure and when and how frequently the list will be reviewed and culled.
If your school is of the DCU variety, then just follow whatever instructions they provide about informing them that you want to stay on the waitlist.
When your school is COY, things are more complex and nuanced. Certainly follow the directions regarding contact, but you still want to convey certain messages. Just be careful not to overdo it. Yes, let them know of significant developments. If you are not sure whether your recently published article or emergency medical technician position is important enough to merit an email or letter, then either use your best judgment, consult your premed advisor, or ask your Accepted admissions consultant.
Mistake #2: Failing to assess or act on weaknesses in your candidacy
Let’s face it, being waitlisted means you’re qualified. The school wants you, just not as much as they want someone else. Because most schools evaluate applications on a holistic basis, and admissions is a highly subjective process, it is difficult to say definitively why someone is waitlisted. However, a waitlist decision generally results from a combination of the following factors:
- The school saw a deficiency in the applicant’s profile and would prefer that others enroll. In the event that those applicants do not accept the school’s offer of admission, the school will offer someone else a spot. (You want this offer to come to you!)
- The application was poorly executed. Failure to clarify one’s reasons for wanting to enter medicine or attend the target school are among the most common execution errors.
- There are many accomplished applicants with similar profiles, and the adcom can’t admit them all.
In targeting your response to your waitlist status, you need to know where you stand.
Right move: Assess the reasons for being waitlisted and respond accordingly.
If you are lucky enough to receive feedback and direction from your waitlisting school, you have your marching orders. Follow them. This is simple and straightforward. While following these instructions, also provide information about new achievements, fit, and so on to ensure that you are handling all possibilities.
However, if you don’t receive any guidance – which is much, much more common – then you must do your own assessment (or ask for our assistance). You need to assess what combination of the three factors contributed to your waitlist status.
Weaknesses in your profile
When your GPA and/or MCAT score are at the bottom end of or below the school’s 80% range, those numbers probably contributed to your waitlist status. You need to address the weakness(es) through additional coursework, a higher MCAT score, and/or a demonstration of the relevant skills in some other way.
A low MCAT score is tough to mitigate. You can retake the exam, but the results come out so late that they are of little benefit to your waitlist campaign. Still, they could help a possible reapplication effort.
Additional coursework – and earning A grades in those courses – is really your only hope when there is a concern about your academic stats. Retaking science courses in which you performed poorly can help mitigate low grades or perhaps even a less-than-hoped-for score in one area of the MCAT.
If you believe that your service or extracurricular activities are qualitatively less than compelling, you need to highlight recent activities that will change that perception.
Problems in execution
If your stats and volunteer/work experience are competitive, look at your essays, recommendations, and resume. They might have kept you from receiving an acceptance notification, and now is the time to fix any problems in these areas. If you failed to clarify your reasons for wanting to go into medicine or for seeking acceptance to this particular program, the waitlist gives you a second chance to do so. Grab it. Certainly for SMULM schools, make sure that the reader of your waitlist correspondence knows exactly why you would attend the school and how it will help you achieve your goals.
Overrepresented groups
Finally, if you are confident that you are competitive and your application presented you well, but you are a member of an overrepresented group in medicine, realize that the school simply cannot admit every applicant like you and create the it hopes to have. You should stress your high level of achievement and interest in the program. If you have unusual experiences, hobbies, or interests that you neglected to mention, let the school know about them so you can earn a few diversity points.
Mistake #3: Being modest about recent achievements
Humility is a treasured trait in medicine, but your waitlist communications are not the time for false modesty, real modesty, or anything in between. (Just remember that arrogance is always out of place.)
Right move: Convince the schools that you are a new and improved applicant.
Show the adcom that your candidacy is even stronger than when you applied. Give the school(s) more reasons to select you by informing them of recent achievements, initiatives, and success stories.
With SMULM, this is easy. Periodically update them on anything of interest. Accomplishments, promotions, research publications, great grades, increases in responsibility (even if not accompanied by a formal promotion), initiatives, community service, and personal achievements (e.g., completing your first marathon, performing in Europe) could all merit an update.
For COY and DCU schools, you will have to be more circumspect and rely more on your fan club to convey the information you want the school to know. I’ll discuss tactics to address this situation later in this post.
Mistake #4: Hiding your genuine interest in the school and your fit with the school’s culture
You probably discussed your reasons for wanting to attend this school in your secondary essays and your interview.
Or perhaps you aren’t really sure why you want to attend this school.
Or maybe you have been rejected everywhere else, so this is your last hope.
There’s no point in elaborating on your interest. Right? Wrong.
Right move: Reinforce the idea that this is the best school for you to achieve your goals.
While your qualifications relative to those of your peers are primary in admissions evaluations, “fit” is a major factor. The adcom members want to know that you will do well in their school not only academically but also in terms of the school’s culture and values. The last thing they want is to admit someone who will drop out – or graduate and later bad-mouth the school.
The adcom also wants to know that their program supports your goals for two additional reasons:
- If the school’s program and strengths support your goals, you will have an easier time matching for residency, which will make the school look better overall. And yes, appearances count.
- The more the program supports your goals, the more likely you are to enroll, which would make the school’s yield go up, or at least not go down. (“Yield” refers to the percentage of accepted applicants who matriculate and is one measure of a school’s competitiveness.)
So, for a host of reasons, it behooves you to demonstrate your fit with the school, repeatedly and in a variety of ways. If you haven’t taken a tour (in person or virtually), attended a welcome day, or taken advantage of whatever else the school provides for prospective students, do so now, if at all feasible. Even if the school doesn’t weigh visits in making admissions decisions (and most do not), visiting campus is a concrete demonstration of interest. Furthermore, the visit gives you material that you can include in an update, discussing how the visit or virtual event reinforced your interest in the school. As you relate your experiences and achievements to your reasons for wanting to attend your target med school, you’ll strengthen the impression that you really want to attend and will matriculate if accepted.
And, as with letters of recommendation and essays, including specifics that illustrate and support your claims will help persuade the admissions reader and add to your letter’s effectiveness. Claims that aren’t backed up with anecdotal evidence sound empty.
Mistake #5: Not seeking expressions of support
Now is not the time to sit around, hoping people will offer to help you. This is a time to get off your duff, network like mad, and enlist the help of individuals in your corner.
Right move: Solicit expressions of support from your fan club.
Take the initiative so that the school receives a steady stream of substantive recommendations. A letter of support is typically a one- or two-page expression of someone’s endorsement of your candidacy. To be effective, these letters must add value to your application. They should not merely rehash your resume, earlier letters of recommendation, or your essays; they should inform the adcom of events that have taken place since you submitted your application or present another/new facet of you.
At an SMULM school, your fan club is helpful, but it can be critical at most DCU and COY schools for one simple reason: your fan club is not bound by the schools’ instructions. As fans, they want to help you, and they haven’t been told, “Don’t call us. We’ll call you.” In particular, alumni and students of your waitlisting school can attest to your fit and mention your recent achievements in their letters of support, thus giving the school – which would otherwise remain regrettably ignorant – more reasons to admit you.
(Although your fan club isn’t bound by the school’s instructions, if any of your waitlisting schools say that they don’t want letters, be sure to respect this preference. Contact your waitlisting school to learn its specific policy. A number of top medical schools explicitly state that they won’t consider letters of support. If a school is not open to such letters, don’t submit them.)
So, who are the members of your “fan club”? They are friends, acquaintances, and professional colleagues who can write letters of support on your behalf.
A+ fans
The best fans know you well, have worked with you, and are students at or recent alumni of your waitlisting school. They can attest to your strengths and accomplishments and reinforce that you have the attributes the school values by drawing from personal experience and using examples. These are your A+ fans.
People with knowledge of the program
This group of fans primarily includes students and recent alumni but could also include research colleagues and professors. For instance, if your cousin’s girlfriend completed an MD or DO at your waitlisting school, call up your cousin, tell them about your waitlist news, and ask whether their girlfriend could help you out with a letter of support. Then meet your newfound supporter and tell her what you have been up to, emphasizing recent events and experiences that are not yet a part of your file. Give her your resume/CV and a synopsis of what you would like her to spotlight.
People who know you well, either from work or a community service/nonprofessional setting
Peers, professors, physicians you have shadowed, and bosses can all submit additional letters of support for you. Your official recommenders can also update their recommendations with more recent material. If you are involved in a community service organization, sports group, club, church, political organization, or trade group, ask someone from this part of your life to write a letter of support on your behalf.
These people will probably know less about the waitlisting school than the students or recent alumni, so be sure to offer them some guidance with respect to the school’s values and the qualities you would like them to highlight. The AAMC’s list of Professional Competencies might be helpful for them to review before they sit down to write. These recommenders will usually be able to comment more on your interpersonal skills than on your academic qualifications, and that’s fine.
On the other hand, who should never contact a medical school for you, even if they really want to help? Your parents, your grandparents, the neighbor you babysat for, or your high school teachers.
How to submit letters of support
If you have received instructions on how and to whom you should direct correspondence, follow those instructions. Be sure to pass these instructions along to any supporters who will be writing or calling on your behalf.
People who have connections at the schools should send their letter to their connections and cc the admissions office or waitlist manager. If your supporters are most comfortable making a phone call, let them. Remember, they will know better than you how to use their network.
Mistake #6: Planning a one-time deluge of correspondence… followed by deafening silence
By now, I’m sure you realize that passivity while on the waitlist is a recipe for rejection. So you might be itching to flood the adcom with follow-up materials, especially if you are targeting a SMULM school. Resist that urge! You don’t want to clog up their inboxes and then disappear.
Right move: Plan a campaign of steady, substantive contact.
You want to maintain contact, demonstrate interest, and keep your name in front of the adcom in a constructive and positive manner. Pursue the golden mean between poisonous passivity and nagging nuisance.
Depending on what time of year it is and what’s going on in your life, once a month is a good guideline. If you are waitlisted early – let’s say in November – your correspondence initially will be less frequent than if you are waitlisted in March. The waitlist shrinks much more quickly as the application season rolls on.
Here are a few sample schedules for hypothetical applicant profiles. You probably won’t match any of them exactly, but they should give you an idea of different factors to consider in developing your waitlist campaign.
Sample #1
Ali is waitlisted at an SMULM school in January. They have great stats but have worked as a lab assistant with little opportunity for leadership and minimal clinical exposure in the two years since they graduated from college. However, they recently became a team lead at work and started volunteering at a local organization that serves children with cancer. The following table outlines their plan.
| Action Date* | Target Date** | Action |
| January 1 | January 7 | Respond to waitlist letter and update the school about new responsibilities and volunteer initiative. Inquire about ways to improve profile. Reiterate reasons for wanting to attend. |
| January 15 | February 1 | Ask boss to send a letter of support confirming new responsibilities and qualifications. |
| February 15 | March 1 | Ask Harry (who attends the med school) to write a letter of support. |
| February 20 | March 1 | Contact school about visiting in early March, or register for virtual event. |
| March 5 | Visit school/attend virtual event. Meet with students on campus or virtually. Attend class. Take tour. | |
| March 6 | Send thank-you notes as appropriate to the tour guide and/or students who provided their email addresses. | |
| March 7 | April 1 | Ask the head of pediatric group to write a letter of support referencing work with sick children. |
| March 15 | Write adcom to highlight ways in which the school visit confirmed interest in the school. | |
| April 15 | Write school and update them regarding success of community service and challenges of working with people from different cultures. | |
| April 15 | April 25 | Ask colleague from work to write a letter of support. Focus on interpersonal skills. |
* Date applicant acts.
** Target date for others to carry out request.
Ali is accepted on May 10!
Sample #2
Robin is waitlisted on April 1 at a COY school. They served as captain of their NCAA team, participated actively in their Greek house, and worked part-time. Their grades show that they didn’t spend much time on their studies: 3.4 GPA overall; 3.2 in science courses. Their work experience is strong: they worked for four years at a biotech firm and have been a team lead on engagements in the United States and abroad. They also founded and serve on the board of a foundation that helps people suffering from a rare hearing disorder – one that afflicts their mother. They have a 517 MCAT score, evenly balanced. Their grades are clearly their Achilles heel. As a result, they have retaken organic chemistry and microbiology in the fall and spring semesters. They earned an A in organic chemistry this time and have As on microbio tests in their current course.
| Action Date* | Target Date** | Action |
| April 7 | Follow instructions for informing school they want to remain on waitlist. | |
| April 10 | April 15 | Talk to supervisor about a letter of support. Contact friend who is a student at COY, requesting a letter. |
| April 20 | Contact COY rep to ask whether academic news is something they would want to know about. Answer: Yes. | |
| April 25 | Send one-page letter to adcom informing them of academic progress and reiterating interest in the school. | |
| May 15 | June 1 | Consider visiting school again.*** |
| May 15 | June 1 | Talk to CEO of foundation about sending a letter of support. |
| June 1 | June 15 | Ask teammate to send letter of support focusing on teamwork skills. |
| June 1 | June 10 | Ask community college to forward transcript showing A grades in organic chemistry and microbiology. Enroll in genetics class for summer. |
| June 5 | Send in requested update.*** | |
| June 10 | June 25 | Ask peer/COY school alumnus to send a letter of support. |
* Date applicant acts.
** Target date for others to carry out request.
*** Robin decides against a second visit, because they already visited, and the adcom made it clear that they don’t want to meet applicants. Robin hears about a virtual meeting aimed at next year’s applicants and decides to go to that event (June 3). There, they talk to an adcom member and mention a change in responsibilities. The adcom member asks for a written update.
On June 26, Robin hears that their name has been removed from the waitlist, but they are strongly encouraged to continue taking classes and reapply next year.
Sample #3
As Charlie is preparing for their last set of finals in April, they are waitlisted by School X. They have already been accepted to School Y but would rather attend School X. They have no obvious weaknesses in their profile and rich multicultural experience. Charlie realizes they really need to make use of their fan club for this school, and the school has not commented on submitting letters of recommendation.
| Action Date* | Target Date** | Action |
| April 15 | Follow instructions informing school of desire to remain on the waitlist and send an immediate update. | |
| April 15 | May 1 | Ask a close friend who is a student at the school to write a letter of support. |
| May 1 | May 15 | Ask supervisor to send an additional recommendation. |
| May 5 | May 25 | Send a letter of intent with a brief update about new activities at work. |
| June 1 | June 15 | Ask colleague at not-for-profit where Charlie volunteers to send a letter of support. |
* Date applicant acts.
** Target date for others to carry out request.
On June 25, Charlie receives a letter from School X and decides to attend. They indicate their intention and request that School Y release their seat.
Don’t treat these schedules as set in concrete. If you know when your school will cull its waitlist before a specific decision date – for instance, right after deposits are due from accepted applicants – you might want to submit an additional letter or update, even if one isn’t scheduled. If a supporter is a little late or early with a letter of support, don’t get overly upset. Just thank them and move on. The adcom doesn’t know your schedule.
Mistake #7: Complaining to the school about the agony of being waitlisted
Don’t wax eloquent about the pain and shock of being waitlisted, the agony of a pseudo-rejection, or the embarrassment of telling your friends and colleagues. And for heaven’s sake, don’t think for a second that the adcom made an incredibly stupid, unthinkable mistake because you’re a gift to the medical community!
Right move: Thank the adcom for its continued consideration.
Period. End of story. Move on. Discuss your qualifications, fit, and so on instead.
Mistake #8: Providing hyperbolic apologies for weaknesses or mistakes
Why bother with an exaggerated apology? All an overblown apology will do is shine a spotlight on your flaws and failings.
Right move: Highlight the positive.
I have encouraged you throughout this blog post to address weaknesses in your profile. At the same time, you don’t want to draw undue attention to those imperfections. Am I contradicting myself? No. You need to address your weaknesses and – without emphasizing the negative.
For example, if you scored 125 on the biology section of the MCAT, have a liberal arts background, and took the minimum premed requirements in college, earning a 3.2 in those classes, don’t start apologizing for your “weak” science foundation. Without mentioning your MCAT score or your mediocre performance in undergrad science courses, say that you have enrolled in a genetics class to prepare for medical school. Oh, and for that same reason, you retook organic chemistry last fall and just found out that you earned an A.
If for some reason you must refer to a negative, don’t exaggerate it. I recently read an essay in which the applicant went on and on about his “dismal grades” and “dreadful performance.” This is not the place for inflated language. Minimalism, please. Similarly, don’t refer to your “lengthy absence from volunteering.” If you must refer to an “absence,” limit it to that word alone, or better yet, simply tell the adcom that you just started volunteering or shadowing a physician or anything else without reference to the gap and the negative.
Mistake #9: Playing “hard to get”
If you think you can impress your waitlisting schools by telling them that you have other offers, you are sorely mistaken. Such a tactic can backfire completely.
If School A hears that you have been accepted at School B, the School A adcom might become concerned that you would prefer School B – in which case, accepting you could hurt School A’s yield. Alternatively, School A might believe that it is more desirable for any number of reasons and resent your ploy, seeing it as an unwelcome pressure tactic showing a lack of judgment. Again, trying to play one school off another is completely counterproductive.
Right move: Inform your waitlisting school of other acceptances only if you are at a point where you will remove your name from the list if you don’t receive an acceptance.*
When time has passed and you have reached a point of no return, or are close to it, you have nothing to lose by approaching the waitlisting school. You have made your best effort, and time has marched on. You must commit to one school or the other.
Because you will accept the offer of admission at the first school if you don’t hear positively from the second/waitlisting school and would prefer to attend the latter, contact the admissions office. With humility and modesty, explain your situation. Ask the human being on the other end of the line if they can help you.
The adcom member might say, “I’m sorry. I appreciate your situation, but we don’t have a spot for you now and won’t be evaluating the waitlist again for another two weeks.” If that’s the case, thank them for their time, and accept the offer to attend the other school.
On the other hand, the adcom member might say, “We met this morning, and you’re in!” Or, “We are meeting this afternoon. Can I call you after we meet?” In this case, your phone call paid off.
* If the school asks you directly whether you have been waitlisted or accepted at other schools, answer the question honestly.
The right moves
Now that we’ve reviewed the top nine waitlist mistakes, let’s take a second look at the nine things you should do as a waitlisted med school applicant:
- Follow the directions contained in the school’s correspondence that informs you that you’ve been waitlisted. If the school says, “Jump!” you should ask, “How high?”
- Assess the reasons for being waitlisted and respond accordingly.
- Convince the schools that you are a new and improved applicant.
- Reinforce the idea that this is the best school for you to achieve your goals.
- Solicit expressions of support from your fan club.
- Plan a campaign of steady, substantive contact.
- Thank the adcom for its continued consideration.
- Highlight the positive.
- Inform your waitlisting school of other acceptances only if you are at a point where you will remove your name from the list if you don’t receive an acceptance.
What now?
Accepted’s admissions experts are ready to help you get off the waitlist and into the medical school of your dreams. We’ll help you identify areas you can highlight in your waitlist letter, assist with strategy, and support you in editing your letter so you can be sure it makes the best possible case for your admission. Schedule a free 30-minute consultation, and let’s get started.
Since 2001, Cydney Foote has advised hundreds of successful applicants for medical and dental education, residency and fellowship training, and other health-related degrees. Admissions consulting combines her many years of creating marketing content with five years on fellowship and research selection committees at the University of Washington School of Medicine. She’s also shared her strategy for impressing interviewers in a popular webinar and written three books and numerous articles on the admissions process. Want Cydney to help you get Accepted? Click here to get in touch!
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