Just to add to
@LizzyM and
@Mr.Smile12
The system is perfectly fair. It provides the medical schools with the most efficient method to choose candidates who will both succeed in medical education as well as be physicians for the multiple communities that they serve. Oh you mean fair to applicants? Simple, you are perfectly free to apply or not apply. There is no one forcing to endure this system. However, the moment you apply to a school via listing on a properly submitted AMCAS application that then gets forwarded to a school, you are agreeing to abide to each individual medical's schools student handbooks, all of which have a section for applicants, and to the policies, process and procedures that each school has developed, and which are published and can be found in multiple places usually on the school's website.
Applicants also fail to understand a key logical point to this process. Schools are NOT deciding on acceptance or rejection; they are asking the question "do we admit this applicant?" And I am sure all you premeds, the F'ing Hell are you talking about? Every who applies to medical to medical school starts with the status of "unaccepted." You all start there. Unless the school changes that status in offering you acceptance, there is no reason to inform as you are still in the same status as well you submitted your application. Would it be nice for the medical schools to let you know if you are still being considered? Yes it would be nice, but the expectation that the school owes you this or it is required is just that, an expectation. It is a desire, a hope. As I tell all applicants, you start as unaccepted, and with 60% of applicants not being offered admission, you must you assume, that you application will be one of those. Having any other hope with usually be met with stress, worry, and anxiety often ending with those hope crushed. This is the reality of applying to medical school. Indeed with nearly a million individual applications submitted a year, and under 200,000 getting action (ie pulled for an interview).
And the numbers, both in dollars and in applicants, means most adcoms barely can keep their heads above water with what they have to do. The application process for schools is a money loser with most institutions running somewhere between $3,000,000 and $5,000,000 dollars in costs, in actual expenditures for dedicated staff and systems, as well as lost revenue/productivity for faculty, especially clinicians, to deal with applications.
As for the technical answer to the OP's original question, each school must develop the three P's of Policy, Process, and Procedure for admission in order to get accredited by the Liaison Committee on Medical Education, which is the only body recognized by U.S. Department of Education as the reliable authority for the accreditation of programs of medical education leading to the M.D. degree within the USA. For applicants, the three P's can be found in various documents on a school's website that would include the mission statement, the student handbook, the admissions committee documents (which can be found in either separate by-laws document or as part of the school's overall committee document), and the admissions website. The information across these documents will usually list in detail the composition and duties of the committee, the factors to weigh when considering a candidate for admission, and guidelines for inviting candidates for interviews, and rules on voting for acceptance. Often schools will have non-public detailed procedures in the screening, evaluation, interviewing, and formal review/votes on application.
