Accept/Decline: Your responsibilities

I posted this last year and got some thoughtful responses, and one or two not so thoughtful. Nonetheless, it is still appropriate as the new wave of interviews is in full swing:

Many of you have spent much bandwidth talking about the suspense of waiting to hear from schools of anesthesia regarding your acceptance into their program. You have also talked about the number of applications and interviews that many of you have completed. May I suggest to you that schools spend a lot of time (and sometimes money) in preparing for you and your classmates to hit the ground running after a nice "get acquainted" social activity of some sort. In fact they spend a GREAT DEAL of time. It affects everyone, including those on the list of alternates, when you don't notify schools that you do not plan to attend after they have sent a letter of invitation to you. In fact, it might well mean that an alternate cannot attend because of the thoughtless acts of an applicant who was accepted into a "higher choice" program and neglected to inform the other programs of that decision. Please be considerate of the schools to which you've made application, the students who would have been your classmates, and especially the alternates who are waiting by the phone to hear if an opening has magically appeared. Please notify the schools who have offered a seat in their program to you if/when you decide to decline their offer...it's the professional thing to do.