I applied to them four times, they interviewed me and waitlisted me three times. I of course also applied to DO as well as one international school during the various rounds. TCS has a very good reputation (particularly in the South), pretty good research facilities (admittedly I have not explored them), an award-winning LGBT clinic, and has a really fancy new education building which puts most Ivy League schools to shame and they are revamping part of the curriculum which is likely only going to make it better. There is a bonus of it being incredibly affordable thanks to me being in-state. I don't want to say this is my ideal school, but it is pretty darn close. For those familiar with the "Dayenu" portion of a Passover seder, if I was just accepted to medical school and it didn't have a good reputation, it would have been enough Dayenu. Instead almost every single thing I asked for in a school is right there. Only thing is that it's not closer to my shul or on the Jewish calendar but you know what? I'll take it! My shul is only 2.5 hours away. I could run down there every other week and I assume I can ask for religious accommodations for the first two years.
I will say I have seen and felt so much absolute sadness the past few years every time I was reapplying that by the time the waitlists hit this year, they didn't even hurt so imagine my shock when I was accepted right as I was preparing for round 5. It's entirely possible that I would not have appreciate the acceptance as much as I did if I was accepted the first round.
However, I've I have a few basic things I learned during my saga and as I think of other things, I will update this post to reflect new additions. Some will be obvious and others, maybe less so.
Obvious Application Improvements
In all likelihood, just due to the way things work, you have very little time to improve your application from the time round 1 rejects you to the time round 2 starts, That is, of course, assuming you did little or nothing after you clicked "submit" on round 1. Hopefully, you continued to do something, whatever it might have been, during the interview season to make your round 2 a little better, but I suspect if you are reading this now, it might be too late on that end.
Personally, I am a huge fan of looking ahead. By the time I hit "submit" on round 2, I was looking for ways to make my round 3 look better. I did this every single year. So here are the usual areas that might need help.
1) Grade improvement - In all likelihood, the movement of your GPA caused by classes taken during a surprise gap year isn't likely to be a ton, although anything is possible and that is of course contingent on how many hours and how many grades you have. I would be surprised if this would make a difference unless you were doing the DO grade replacement option which is a really wonderful tool, but unfortunately for the MD programs probably won't help much. My differences were in the few hundredths of a point. I can honestly say that making the decision to take GPA-boosting classes was probably not the best use of my time or finances. The only benefit is that I took classes that I always wanted to take, but never had the chance.
2) MCAT improvement - This here is likely one of the easiest ways to boost your chances of acceptance for the next round. I've spoken a little about my MCAT review here. I wish I was able to take professional grade MCAT classes, but my finances just would not allow it. Of course, if your MCAT is the old score equivalent of mid-30s, MCAT is probably not an issue.
3) Clinical Experience - I am sure this comes as no surprise that an increase in clinical experience would be very helpful. Exactly how much you can get during a surprise gap year and the quality of the experience is hard to assess. At a minimum, hopefully, you can get some shadowing or some volunteer work. If you really have the time/money/energy, becoming an EMT is a good choice. Some schools offer accelerated EMT-B courses either in-person or online. I requested the information from three of them, but never signed up for the classes as two had horrible bad timing (interview conflicts) and one had issues with my paperwork. I would suggest doing your due diligence, signing up for a course and complete it and get a few hundred more hours of clinical riding on the truck. There is also the option of scribing, which I interviewed for but did not get. Apparently, ScribeAmerica felt I was likely overqualified. Fair enough. I would have not been able to fulfill my commitment if I had been offered the job, so that perhaps was for the best.
4) LOR - Reassess your LORs if need. My first year there was a questionable LOR sent on my behalf. The man dictated a letter and he had a thick accent and he did not proofread it, so the letter made no sense. Once I removed his letter and replaced it with a different physician letter, then TCS interviewed me three times in a row. I was told all my letters were outstanding, at least once I replaced that letter.
5) Research - If you like it and everything else is solid, go for it. Don't do it because you feel like you have to though. If you are incredibly lucky, you might be able to get a publication or presentation out of it in time for your next cycle. Clinical is more important than research.
6) Community service (non-medical) - If you are low on this, it really can't hurt to get a few hundred hours in.
7) Interview skills - This is obviously more important if the rest of your skills are pretty solid and you were at least getting interviews. There are tons of ways to get mock interviews. Friends, family, etc. Some times there are even people who offer mock interviews on SDN. Get someone known for being a hard nose which is exactly what the interviews might be like in the worst case scenario. There were many who suspected it was my interviews who killed me, and the later mocks (early round 4) were different from my very early mocks (pre-round 1), because I had about a dozen real job/medical school interviews in-between, plus being interrogated in another country under pressure probably improved my interview skills more than I could imagine. After that, no interview could be that bad!
Improve yourself in general
It's always good to improve yourself of course and frankly, if you have already hit the point of diminishing returns above, you have to do something to fill your time and improving yourself can't hurt. "Improve myself? But I'm PERFECT!" No... you aren't. No one is. If you think you are perfect, you definitely need help.
1) Learn Humility - I think one of the bigger things that changed from round 1 to round 4 was this character trait. I am certainly not going to lie, I have an ego at times. I can "humble brag," with the best of them as I have been everywhere and done everything. However, I know my various arrogance was much more obvious 4 to 5 years ago. Why? Because if nothing else, medical school rejections is very humbling. I cannot help but wonder if my arrogance level from eons ago hurt me more than helped me. I remember when I was trying to do a PB that I said I could do better than SPBU where they had their linkage. That was probably an incredibly bad move and I regret it entirely. While I could end up doing better than SPBU (and did, I ended up at TCS) it took many more hard and long years to prove it.
2) Follow Wheaton's Law (aka "Don't be a dick")- This is such a huge factor that I can't even tell you. There are so many rude pre-meds who in part are also dealing with a humility issue, but they treat people horrible. Most people know to be polite to admissions offices, but don't realize they can find out who you are.
You can't even depend on your anonymity on forums such as "Student Doctor Network," you really can't. Those adcomms will figure you out most likely. We take such time in hiding where we went to school or hiding our real names, but do stupid things like state when we are interviewing and give identifying information or stats. They know who we are or can figure out with little effort. While I have only given my real name to a handful of SDN folks (3 are friends on FB now, one adcomm knows a first name, I think another knows a husband's name as well, there are probably a few more that know my first name), finding out who I am is not the hardest thing in the world. I think one thing that is important is to remember this and just assume that anything you post is going to be seen by adcomms and they are going to hold it against you if you are a jerk regularly. Heaven knows I've had my share of bad days on SDN and otherwise, but I very rarely troll anyone, unlike many on SDN which is one reason my undergraduate school called it the "Website that shall not be named."
3) Learn a language - Hey can't hurt!
4) Try new experiences - You have a year, do something fun! Work on your bucket list. During my "rounds" I've gained 5 states, 3 countries, went skydiving, swam with manatees, saw a dog race (the dogs ended in order!), went to a film premiere, visited several Roadside America attractions, sat on a selection committee for the biggest Jewish film festival in the world, went to a rodeo, learned two instruments, and worked on three languages.
5) Move - There is a Yiddish saying, "Meshane Makom Meshane Mazal" if you change your location, you change your destiny. I moved by force to a town of 100 people to a mountain which has only two houses on it and my destiny changed.
1) Keep a sense of humour - The application cycle is incredibly stressful, but then so is medical school. Going through it again and again will get to you. However, after a while you need to be able to laugh at it. I said that for round 5, one of my activities was going to be swapped out with "Hobby: Applying to medical school" which in all fairness this is one of the more expensive hobbies I've had. ;) I also joked and said that I was going to tell TCS to not bother interviewing me for round 5 and instead to move me directly to the waitlist to save them time and me money. Just remember there is always a bit of truth to humour. Just remember TS Eliot said "Humour is also a way of saying something serious."
2) Avoid giving up - Do you know the only way to assure you are not going to get into medical school? Don't apply!
3) Don't worry/Pretend like you don't care - Don't do this on interviews obviously, but at home once it is out of your hands, it is out of your hands. Try not to worry about it even though obviously you care.
4) Use Reverse Psychology on the powers that be or on yourself - My life has always been kinda like the following exchange.
Person1: Do thing 1.
FA: I don't want to do thing 1. I want to do thing 2.
Person1: Do thing 1.
*several years go by*
FA: I think I want to do thing 1.
Person1: No. *throws roadblocks in the road*
*several years go by while FA climbs over roadblocks*
FA: But I really want to do that thing.
FA: Fine! I am even more so qualified to do thing 2 and I've spent years trying to do thing 1. I WILL DO THING 2.
Person1: *holds acceptance letter or award for thing 1*
I knew I was going to have to stop caring because only when I stopped caring would I get in. I literally was trying to learn Hebrew so I could move out of the country and I was doing to try to make aliyah within a year and finish my yeshiva studies and become a rabbi in Israel along with being a writer. And then it came in.
4) If you are religious, pray - It can't hurt! Do you know how many times I sent a letter to the Western Wall or 770 for prayers? Come to think of it, don't ask.
I'm sure there are much more things to do, but this is a start.