Schools want the best candidates. So they’re highly selective at the beginning. Choosing to accept a much smaller number of students at the beginning, placing a small majority of the rest in waitlists, and rejecting a similar number in those who they interview. As these smaller acceptance numbers increase from August to December, some of those accepted will begin to “release” their acceptances in favor of schools they prefer (depending on what they are looking for, e.g. highly rank schools, name recognition, closer to home, cheaper cost, city vs smaller town, possibly higher ranking with residency match percentage, etc). So, by December, many of these students will begin to release their positions, in favor of schools they really want to go to. Remember, students choose not just ranking but also closer to home, costs for medical education, etc. So if you have a choice of school to go to, you will have options. As students release their acceptances, the school then will bring from other from their waitlist. These students in the waitlist are just as good as the ones they initially accepted, so the school is happy. The students they bring up to the next tier and accept may have that school as their top choice, so then they release acceptances from other schools, henceforth opening up more acceptances from the schools they released. Similarly, the students who then get their “top choice,” may start releasing interview dates from schools lower on their list, so more interview invites come to those who have yet to be invited. Domino effect. By January, more of these are happening, and that’s why you see a big dump in January in the schools with rolling admissions. Also, the acceptance dump is dependent on how popular the school is. Highly sought schools tend to dump in January, but I’ve seen other schools dump in February or later. By the date of commitment, some schools will lose more “acceptances,” so they dip even more into their waitlist. Remember, the ones on the waitlists who schools eventually bring up to their accepted tier are just as good as the initial ones they accept, but in doing this, the schools get the ones who really want to go to their school. The students they waitlist fit their mission and vision for their school, so they don’t lose out and thus the schools are happy. The process is similar to the residency match. In this way, the students (who are very qualified to go to medical school) “match” with the school they want and likewise, the school will match students who they want. Good luck to you all. Hope that sheds some light into the process. Bottom line is: don’t lose hope. As long as you haven’t gotten an R, your application is still alive and you still have a chance for that school (esp if you’ve already been interviewed).