There is a lot of variation. Big crapshoot. Have good recommendations. Have something in your materials that you want to highlight as your "thing" or theme (something they might remember a bit...) Follow up with the office with polite persistence. If waitlisted or unknown status, email once per week or two to reassert enthusiastic interest.. and thank them for their time and consideration etc. Expect that you will get no reply from these emails. That is expected. However, trust that the assertions of continued enthusiasm are still being duly noted. Unload your frustration about the process at the bar with friends later. Seriously avoid the temptation to give an admissions rep an earful. Also, in your weekly email, ask if there are any further admission material you could submit that might be helpful. Even if they ignore email and don't ask for further credentials, drum up a couple good new solid things. slip a manila envelop under admissions office door during some weekend and include a couple new recommendations from maybe less expected sources but are very positive and perhaps reveal sides of your life/work that were not otherwise shown in initial app. Also throw in an updated/expanded resume and and a cover leter talking about how your most recent experiences in blahblah have made you even more super gung ho about seeing yourself in their wonderful program dadada. The admissions office, like all of healthcare, is woefully understaffed for the task at hand. You want your app at the top of the pile because your dogged enthusiaism and growing paper trail keep it in active circulation. Dont let your app languish from lack of followup BUT dont make the admissions officers's lives harder or more unpleasant in any way (that will get your file languishing under the desk too). In admissions and in in real healthcare life people want to bring aboard and work with people who will makes their lives and jobs easier.... That said, both admissions and job search are crazy crap shoot. It's the economy. Don't blame yourself. But these are best suggestions i can come up with from my experience of being on downstate waitlist for a long time and then finally getting in.