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To investigate current medical school admission processes and whether they differ from those in 1986 when they were last reviewed by the Association of American Medical Colleges (AAMC).In spring 2008, admission deans from all MD-granting U.S. and Canadian medical schools using the Medical College Admission Test (MCAT) were invited to complete an online survey that asked participants to describe their institution’s admission process and to report the use and rate the importance of applicant data in making decisions at each stage.The 120 responding admission officers reported using a variety of data to make decisions. Most indicated using interviews to assess applicants’ personal characteristics. Compared with 1986, there was an increase in the emphasis placed on academic data during pre-interview screening. While GPA data were among the most important data in decision making at all stages in 1986, data use and importance varied by the stage of the process in 2008: MCAT scores and undergraduate GPAs were rated as the most important data for deciding whom to invite to submit secondary applications and interview, whereas interview recommendations and letters of recommendation were rated as the most important data in deciding whom to accept.This study underscores the complexity of the medical school admission process and suggests increased use of a holistic approach that considers the whole applicant when making admission decisions. Findings will inform AAMC initiatives focused on transforming admission processes.