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Hey there. Definitely a bit of a tough situation. I number one want to emphasize that personal wellness is extremely important, not only for life in general, but for doing your best at academically and personally challenging tasks such as doing a post-bacc, studying for the MCAT, or succeeding in medical school. That should be your first priority.
In order to build a successful medical school application, you basically have to have the following things:
1. good GPA
2. good MCAT
3. Active clinical experience (paid or volunteering)
4. Shadowing (i.e. passive clinical exposure)
5. Non-clinical volunteering
6. Research (not totally necessary but definitely helpful)
Let's start with what you have, then what you need to do, and then we'll prioritize and come up with a plan.
First, you have a ton of active clinical experience in the ED and as an EMT. That's excellent, and you don't need any more for application purposes, even if your narrative is that you want to do emergency medicine.
You have leadership being an executive for the neuroscience non-profit. If you participated heavily in the teaching and were not paid, that can count as non-clinical volunteering.
You have a GPA of ~3.35 and an sGPA of ~3.1. Those are both very low compared to the average MD matriculant and still low compared to the average DO matriculant. This is the biggest "problem" with your app that we need to address. There are two ways to do this. The first is a post-bacc and the second is an SMP. A post-bacc is usually used to fulfill science requirements while an SMP is usually used to overcome a low GPA, though either can be used for either purpose. I think that given your GPA combo of 3.35/3.1, an SMP would be the best move if you wanted to apply both MD and DO (it is very unlikely you'll be safe applying to MD only). A one year post-bacc of only science classes with a perfect 4.0 would raise your cGPA to a max of about 3.48 and your sGPA to maybe a 3.3 at best. Those combined with a good MCAT would give you a pretty decent shot at DO schools, but would still be essential DOA for MD. A strong (better than A minus average) SMP showing with graduate level work would help obviate any concerns that you are not academically prepared to enter medical school. This is why I recommend an SMP over a post-bacc in your scenario.
Regarding the MCAT, you have a great strategy of wanting to hit or surpass your target score on multiple practice tests before taking the real thing. Keep in mind that your MCAT score is only valid for 3 years, so I would recommend taking it after your SMP + a couple months of study.
Shadowing is important in addition to active clinical experience because they serve different purposes. Active clinical experience demonstrates that you know what it's like to actually work in a healthcare environment with patients and you want to be in that setting for your professional life. Shadowing gives you an idea of what the day to day of a doctor in practice actually is which helps you be convincing when you say you want to be in that role. I would recommend one office-based (preferably primary care) specialty and one hospital-based inpatient specialty (though you can shadow only primary care if you so choose). A letter of recommendation from a shadowing gig is never useful and doesn't contribute to your application. However, DO schools require a DO letter of recommendation just to basically say you know what a DO is, so you can knock out two birds with one stone by shadowing a DO primary care physician and asking for that letter (don't send it to MD schools).
Non-clinical volunteering is pretty far down the list now, but still important. If what I said earlier about the neuroscience non-profit isn't totally true, then you'll need to sneak some hours in here somewhere, but it's low on the priority list. Find something you enjoy doing and where you can make a difference and even give a couple of hours every other weekend.
Finally, research is nice to have, but given the schools you're likely to be targeting, your goals of being an ED doc (a traditionally non-research driven residency match), and the other things we need to prioritize, I don't think you will need or should allocate time to research in order to be a successful medical school applicant.
In terms of where to apply, you should know that CA is a hard state to be a premed from because it has a high volume of in-state premeds that want to stay in CA. This means you will unfortunately have to be flexible from a locational standpoint. You will also have to apply to both MD and DO schools (unless you absolutely annihilate both your SMP and your MCAT, in which case come back and we'll talk), but fortunately there are are several DO schools in the western US as well.
I know that's a lot, but thanks for bearing with me and here is what I would recommend as your roadmap to success:
1. SMP with >3.7 performance -- while doing this, shadow and do a little bit of non-clinical volunteering every so often
2. MCAT after SMP + several months of studying
3. Come back to SDN with your new stats and buffed ECs in the spring before you need to apply (think like March/April) and we can help you make a school list
4. Apply day 1 that the applications come out
Best of luck, and please let me know if you have any questions!
