Medical School Hold Status: What It Means

Medical School Hold Status: What It Means

A hold means no decision yet, but schools use the word for two different moments: before an interview (UC San Diego, Mayo, SUNY Downstate, Touro Nevada) and after one (Penn State, OHSU, MUSC, Downstate again). What you may send while on hold depends on your school's own definition.

It is easy to read "hold" as one status with one set of odds. It is not. A pre-interview hold at UC San Diego means you may still be invited. A post-interview hold at Downstate is the step before an April alternate-list decision. Penn State's "Hold for Continued Review" lets you send exactly one document, a statement of intent, and only after April 30. Our view: read your school's definition before you write anything, because the same word can mean wait, send fall grades, or send nothing.

Every school page quoted here was fetched on November 7, 2026. Where a page states no cycle year, the quote is what the page said that day.

The two holds: before an interview and after one

Before an interview. The school has read your file and has not decided whether to interview you.

New to the shorthand? Our list of premed acronyms like II, WL, LOI and LOCI maps each to the official term.

• UC San Diego: applicants may be "Placed "on hold" for an interview. Throughout the application season, candidates that were originally placed "on hold" may be invited to interview at UC San Diego."
• Mayo Clinic Alix: each application is assessed for "invitation to interview, placement on hold for further consideration, or discontinuation from active review."
• SUNY Downstate: "Hold for spring consideration before interview means the Admissions Committee will re-review your application after January 2."
• Touro University Nevada (DO): "If you were placed on an interview hold, your application was evaluated by the Admission Committee but has neither been selected for an interview or rejection."

After an interview. The school has interviewed you and has not accepted or rejected you.

• Penn State: "Applicants will be placed in one of three categories – "Acceptance", "Hold for Continued Review" or "Denied Acceptance"." Files on hold "are continuously reviewed until the class is filled and may be selected for acceptance at any time prior to the first day of orientation."
• OHSU: "If your application is on hold, you may be accepted out of the hold pool at any time before April 30."
• SUNY Downstate: asked whether a post-interview hold is an alternate list, the FAQ says "No. The Alternate list placement is decided in April. Generally, an applicant is first placed on the Hold list to be eligible for consideration for the Alternate list."
• MUSC: "All applicants remaining on "hold status" are reviewed at the last scheduled Admissions Committee meeting for a decision regarding rejection or placement onto the alternate list."

George Washington's FAQ uses a third wording, "on hold for re-review at a later date", without tying it to the interview: "While on hold, you remain under active consideration, and your file will be re-reviewed several times."

Status names by school

Many schools do not say "hold" at all. Here is what 20 schools call the in-between status, what their pages say happens next, and what they let you send. Cells restate the linked page.

For all update rules at 50 MD schools, see which medical schools accept update letters.

Ranked or unranked: what the pages say

Whether your list is ranked matters for one thing: whether a letter could move you within it. Even ranked schools say they do not share your rank.

• Ranked, rank not shared: George Washington ("The alternate pool is ranked, but it is also fluid. The ranking is never shared."), UNLV, UT Health Science Center, Hawaii ("Waitlisted applicants are kept in their rank order based upon the Admissions Committee's composite score").
• Ranked, position told to you: Iowa ("you will be notified of your exact position"), Wisconsin ("you will receive a ranked alternate list position in early May"), and OHSU, which says "we rank the top 120 to 200 applicants and assign each one a discrete number".
• Unranked: Tufts, New York Medical College, UC San Diego, Virginia, Case Western Reserve, Tulane, USF and WesternU (DO). Cincinnati "does not Tier the Alternate pool".

The ranked vs unranked waitlist guide covers what each kind means for timing.

What to send while on hold

Run this in order. Each step has a stop.

If your school allows a statement of intent from hold, our letter of intent samples include a short constructed one.

1. Read the status definition. Is it a pre-interview or post-interview hold? A pre-interview hold at UC San Diego or Downstate means wait for an invitation or the January re-review.
2. Check whether the school takes updates at your status. George Washington encourages updates on hold. Utah says "Application updates for waitlisted applicants will not be accepted." MUSC takes updates only before the interview, so a post-interview hold there gives you nothing to send. If no, stop.
3. Check for a cap. Drexel allows three items for the whole cycle. If you already used your update letter, stop.
4. Check for a named document. Penn State names a statement of intent after April 30. Temple names letters of interest from April. Send that document, at that time, and nothing else.
5. Check you have a new fact. A new grade (where the school reviews grades), a new role, a result, an acceptance of a manuscript. If you have none, stop. Enthusiasm alone is not an update.
6. Use the named route. Portal at George Washington and Tulane; email at UT Health Science Center and Tufts; AACOMAS for coursework at WVSOM and Touro Nevada.

Constructed hold-status update

Constructed example, written by us, not a real applicant's letter.

Context (invented): Matthias Hale interviewed at Ashgrove School of Medicine in October and was placed on post-interview hold. Ashgrove's page, like George Washington's, encourages updates on hold through the portal and reviews grades. He uploads this in January.

Dear Committee on Admissions,

I am writing with two updates since my October interview.

First, my fall grades are final. I completed Biochemistry II with an A and Medical Spanish II with an A-. The transcript is attached.

Second, in December I took over scheduling for the Maplecrest Street Clinic's diabetes education nights. I now recruit the two volunteer nurses for each session, confirm Spanish-language handouts with the clinic's interpreter, and track which patients return for the follow-up visit. Before December, I helped set up the room. Now I am the person patients call when a session moves.

Ashgrove's continuity clinic is still the part of your curriculum I asked the most questions about on interview day.

Thank you for your continued review.

Matthias Hale

The letter body, between the greeting and the signed name, runs 119 words. It reports two facts, says what changed in his responsibilities, and closes with one sentence of interest and no promise to attend. At a school that does not review grades, such as Mayo, he would cut the second paragraph. More situations are in the medical school update letter examples.

Hold vs waitlist at DO schools

AACOM's application-process page says colleges of osteopathic medicine "make admissions decisions on a rolling basis," and its traffic guidelines say "COMs may begin extending offers of admission at any time after the interview." So a DO hold can be short and tied to a missing piece.

West Virginia SOM's FAQ is the clearest example: "The "Decision Deferred" status indicates that additional information may be needed in order to reach a decision at the time of review." The same answer names fall grades and a later MCAT score as examples. If WVSOM is waiting on grades, the AACOMAS academic update is the update. WesternU uses "alternate" and says "our alternates are not ranked". Both schools, and 16 more, are in the DO school update letter table.

What a hold does not tell you

None of the 20 pages in the table gives a hold-to-acceptance or alternate-to-acceptance rate. WesternU says that "a prediction of chances for ultimately gaining admission cannot be provided." Tulane says the number accepted from its acceptance range "varies from year to year". Odds you read on a forum are not the school's.

The countercase: a ranked list told to you, as at Iowa or Wisconsin, does say something. A low number tells you more than a status word. Even there, the pages give no rate, so use the number to decide how long to keep the school open, not to predict an outcome.

Questions about medical school hold status

Is a hold the same as a waitlist?

No, at the schools that define both. Downstate says a post-interview hold is not its alternate list; alternate placement is decided in April. Ohio State's deferred list becomes a wait list after April 30. Drexel moves remaining deferred applicants to the waitlist from mid-April.

Is a hold good or bad?

Neither, by the pages' own wording. It means you have not been accepted or rejected yet. Penn State and OHSU both say applicants can be accepted from hold.

Should I send an update letter if I am on hold?

Only if your school takes updates at that status and you have a new fact. George Washington encourages them; MUSC and Utah do not take them after the interview or on the waitlist. The update letters before an interview guide covers pre-interview holds.

Should I send a letter of intent while on hold?

Only to one school, and only where the school names that document. Penn State allows a statement of intent after April 30. USF accepts one from waitlisted applicants who are certain they would enroll. The letter of continued interest guide covers the softer version.

What does a post-interview hold mean at a DO school?

At WVSOM, "Decision Deferred" can mean the committee is waiting for fall grades or an MCAT score. Send the missing piece through AACOMAS.

Get a free review of your update letter

Get a free Quick Review of your update letter against GradPilot's medical school update-letter rubric. It reads whether your hold-status update names what changed since you applied and whether that change gives the reader a clear account of your work, responsibility or circumstances. If your school asks for a statement of intent instead, use the letter of intent and interest rubric.

More post-interview guides:

• How long after a med school interview to hear back: school-stated decision windows.
• Medical school waitlist update letter examples: what to send once you move to the waitlist.
• Medical school essays hub: every GradPilot guide for MD and DO applicants.

Sources

Retrieved November 7, 2026, HTTP 200. Each school row links the page its status words come from.

• Penn State, MD application process: Hold for Continued Review; statement of intent after April 30.
• OHSU, MD admissions: hold pool; ranked alternates.
• SUNY Downstate, admissions FAQ: both holds; April alternate list.
• MUSC, admissions policies and update request: hold status; updates before interview only.
• George Washington, MD admissions FAQ and alternate status: hold re-review; ranked pool.
• UC San Diego, application process: on hold for interview; unranked waiting list.
• Utah, MD admissions policies: no waitlist updates.
• Hawaii JABSOM, FAQ; Wisconsin, application process; New York Medical College, admissions; Case Western Reserve, FAQs; USF, waitlist: ranked and unranked lists.
• AACOM, The Application Process (2026-2027 cycle): DO schools decide on a rolling basis.
• WesternU, alternate candidates; WVSOM, DO FAQ; AACOM, traffic guidelines: DO statuses and rolling offers.
• Each other school's page, linked in its table row.