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Hi,
1) Would schools know and hold it against me that I'd been accepted previously and turned the offer down to reapply? Does it come across as vain to want to attend the best school possible?
I was accepted to a medical school this year, but am hesitant to attend. Would it be held against me in the application process next year if I opted to reapply with the hope of gaining entrance to a better school?
This theme is common on SDN and has produced fierce debates and lots of anecdotal stories. When one asks what "Schools" would "hold against" you, they can be referring either to adminstrators such as deans who make final admissions decisions in many places, or individuals who read your application and interview you and provide evaluations to the committees or deans who make decisions.
My comments only address the latter and as always, reflect only my perspective.
Simply put, if I were to be aware of someone who had turned down an admission to a US medical school (allopathic OR osteopathic) and was now applying for admission the next year to my research-oriented highly rated allopathic school, I would try to find out the reason they didn't take the acceptance. If there was a strong personal reason (ill parent, spouse got accepted to another school, had a baby, personal health reasons that had changed, etc), I would probably take it into account but would not have it represent a major aspect of my evaluation in either direction. In other words, I'd ignore the previous acceptance.
However, if it was for reasons related to the school - the perspective that they were trying to "move up" and get into a school that was "higher" ranked, I would think that they had a poor understanding and committment to medicine and had unnecessarily wasted a school's efforts in accepting them the previous year.
If I was interviewing them, we would have a nice talk about medicine and life. Then I would give them a very low interview score based on immaturity and lack of understanding of medical education. I wouldn't attempt to blackball them, I would accept that others might override my view and I wouldn't dislike the applicant in any way. I would prefer to grant my higher interview scores to those who hadn't turned down a previous acceptance the year beforehand.
Sorry, this isn't what many here want to hear, but it is what I would do.