With a newly implemented integrative undergraduate medical education curriculum, YourMD and numerous prestigious graduate medical education programs, Oregon Health & Science University (OHSU) School of Medicine (SOM) attracts over 7000 applicants each year. However, a significant amount of admitted applicants declined their admissions offers. Post-acceptance surveys were conducted in the past few application cycles hoping to close this gap in admissions. The objectives of this study are to identify and analyze reasons admitted applicants decline OHSU SOM?s admissions offers and strategize tangible actions to improve acceptance to matriculation ratio.