I would put down positions that can be construed as leadership, even if it's not the typical "I was secretary of this club and organized this long-term service project." For example, I'm including my role as an alumni advisor to a statewide organization for high school students. If you never did anything that involved leadership, I would just be honest and state that instead of trying to shoehorn in isolated experiences where you acted like a leader, because it seems like a very cut and dry question.
I feel you, though. Leadership in extra-curriculars is not one of my strong points =/ Hopefully the time I spent doing other things will make up for that.
Should we describe said leadership experiences, though? Since the limit is 150 words? I want to simply put "SEE AMCAS" but I'll hold my tongue.
Also, after reading some of last year's thread and witnessing the Great Cullings of July and August, I'm wondering if it'd be appropriate to send the adcom an update at the end of July (assuming I survive that long)? So I can update them on grades for my summer classes? I'd also use that opportunity to explain a downturn in grades during a certain semester. I didn't explain in my PS because I really wanted to focus on the positives & my motivations for medicine....but now I see on Tulane's secondary there isn't a place to explain lapses or provide the adcom with "anything else you'd like us to know" like on some secondaries I've received. Would a pre-fall, pre-interview invite update letter not be a good idea?
ETA: I'm very interested in the MD/MPH program, but I'm not 100% sure. Is checking that box just a gauge of interest? Are the combined degree programs' admissions processes separate from those who just apply regular MD? Basically I'd love to talk in an interview about why I'm interested in an MPH, but if I have a better chance of getting in with only MD, that's what I'll be going with.