Actually the academic perspective is no different than it ever was. Medical schools want to know first whether you can academically handle the rigors of Medical school. You are not considered unless you pass this hurdle. You could of course argue that once a certain GPA, MCAT and academic performance is reached that higher numbers are meaningless but we all seem to like to use higher numbers to a point. WashU especially. The expectation that one shadows a physician and has clinical experience before applying to medical schools is I think a good one to try to make sure that one knows what one is getting into. This “requirement” however only requires a relatively short time commitment. Research was a favorite way of getting into the top research schools and many applicants do this today although most of it is quite pedestrian and no one is under an illusion that most of these projects amount to anything more than checking off another box. Extracurricular activities that demonstrate leadership and commitment to excellence have always been important. Most of my medical school, residency and fellowship interviews were mostly about other topics than medicine. I agree that one has to jump through more “hoops” to get into medical school today but the basics have not changed very much.