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Half the interviews I attended mentioned a thank you note protocol. In the professional world outside of medicine, highly qualified candidates are never hired if they don't follow the simple etiquette of a thank you note. Why would medicine be any different?
Well one difference is that there are very few companies that process upwards of 500 interviewees in the same department. Also, I feel that job interviews leave more material/specific points for inclusion in a thank you note compared to how generic most med school interviews can be, but that's just my experience. But point taken, I think that thank you letters are polite. However, in many cases, especially when the school does not mention a thank you letter policy or provide interviewer emails, they often end up being bland and generic (unless you truly had an exceptionally interesting interview experience) and potentially hurtful to your application.