AOA QUALIFICATIONS, copied directly from the AOA website on how members are chosen:
The Constitution of AΩA gives many degrees of freedom to each chapter for the process of election of student members within certain firm guidelines. These can be summarized as follows:
At approximately 16 months before a given class will graduate from medical school, the Councilor must arrange with the dean's office, with the students' permission, to receive in confidence a list of the top quartile as measured by academic performance.
From this top quartile of students, each chapter may elect to AΩA membership up to one-sixth of the projected number of students that will graduate. The Councilor then invites members of AΩA in the faculty who know students and their performance in the classroom and in clerkships to meet in confidence to select students for membership. The chapter may elect up to half of that one-sixth of students in the spring of the third year, and the remainder at any time from the fall of the fourth year until graduation. There is wide variability in the process among chapters. Some elect no junior students, and several elect all student members in the spring of their senior year just prior to graduation.
Those students chosen from the top quartile for election are picked not only for their high academic standing, but as well for leadership among their peers, professionalism and a firm sense of ethics, promise of future success in medicine, and a commitment to service in the school and community. By adherence to these criteria it has happened that one or more of the highest ranked students by grade point average have not been elected to the society.
Each chapter may elect each year up to three residents/fellows to membership and one or two faculty members. These individuals are expected to be selected by a caucus of student members of the society at some time before the induction ceremony during the senior year. With input from faculty members and the office of the dean, one or two alumni/alumnae may be elected each year as well.