Hard, but not a lottery. In the 2025 MD cycle, roughly 45% of applicants matriculated somewhere, according to AAMC data compiled by UConn's pre-medical advising office. That also means more than half of applicants who applied did not get a seat anywhere that cycle.
Most rejections trace back to fixable things, not bad luck: stats that don't fit the school list, thin or inconsistent clinical exposure, a late submission in a rolling-admissions system, or a "why medicine" that reads generic. A strong admissions strategy is largely about closing those specific gaps before they become the reason for a rejection rather than reacting to one afterward.