Medical schools throughout the United States have admission committees that explore student applications using a multitude of criteria when choosing students for admissions into medical school. A great deal goes into the criteria that each medical school utilizes in selecting potential students to enroll in their school. Even though there has been progress in being more consistent with the criteria by developing the AAMC Core Standards for Entering Medical Students and holistic review of admissions, still, all medical schools are not choosing to use these specific criteria. The purpose of this qualitative case study was to determine how medical school admission deans describe the admissions process to determine which applicants will be offered admission to allopathic medical schools in the United States. This case study was steered by the following research question: How do medical school admission deans describe the admissions process to determine which applicants will be offered admission to allopathic medical schools? In addition, the following sub-research question was asked: What role, if any, does the updated AAMC Premed Competencies for Entering Medical Students have on the decision-making process? Four themes emerged from the semi-structured interviews with five allopathic medical school admission deans which included a) decision-making amid individualized committee structures, b) use of the holistic admissions process, c) emphasizing diversity and inclusion in medical school admissions, and d) challenges and continuous improvement in the admissions process. Decision-making was utilized through the lens of the Vroom-Yetton-Jago normative model of decision-making. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]