I want to take a moment to seriously thank the people who have put in the time to give me good-faith advice, encouragement, and constructive criticism on this thread, while I haven't been able to reply to everyone, it has been so, so helpful. So next steps: I'm not going to pretend that I have had an epiphany, I still have a lot of uncertainty and am drawing on multiple sources to consider what to do next, but I will say that these perspectives have been invaluable and I am planning on doing a lot of things different as a result. First things first: this cycle isn't over, and my priority will be to send schools my updates and keep campaigning any way I can to get a spot this cycle.
As for after that, if that doesn't work: I thought
@bngli had some really good advice in particular about setting a "deadline" for myself at 40--it is a hard thing to contemplate for sure, but after thinking about it seriously I agree it is necessary to set a hard *out* to avoid this just dragging on indefinitely. Believe me, it has been an exhausting process! So I have decided if I don't have a spot by 40, that's it. But that doesn't mean I'm giving up! That still gives me 4 years, and a lot can change between now and then!
Until then, I think I'm going to take a break from applying for a few years, and work on myself to make the next time I apply my last--whatever happens. I'm going to try to get my postgrad GPA up to 3.7 by taking a few more classes, but only as a part-time thing. Now that I have some relative financial freedom, I'm going to throw myself into nonclinical extracurriculars and volunteer work, give low-income students the mentorship I didn't have through my tutoring org, maybe even join that jazz band. Some people mentioned leadership--I'm sorry, my comment about being put on management track at Target was just a random throwaway, I didn't provide any detail: to clarify that would have been a whole career, retail management is a skilled profession that people invest years to move up in, not something I could just do for a year to check a box and then move on. But I am in a leadership position in my job now as a Research Coordinator and have quite a large role in the day-to-day running of the trials I am involved in, which I am using and intend to continue using to advocate for patients. Hopefully by the time I apply again some of these trials will be finished and written up and I will have some publications under my belt as well.
As for how I'll use my last cycle, I haven't decided yet. Everything is on the table: the schools you guys recommended, some of which I haven't applied to yet, DPM, Caribbean, Australia... I know it is important for me to be in a job where I both work with patients and think about the science and mechanisms of disease, but beyond that I don't know.
Thanks again!