I know for acceptances nearly all schools email or call to inform you. Rejections can sometimes be silent (no email or status change on website). Most of the time though schools either change the status on their website or email you to inform you.
I wasn't rejected from UC Irvine last year until maybe 2 weeks after I had already started at another school. There was literally no correspondence post-interview until then... which spanned about 8 months. That really rubbed me the wrong way.
Snail mail is still used by a number of med schools to communicate final decisions. You can check the School Specific threads in PreMedAllo to see what is usual for your schools of interest.
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