Im guessing there are plenty out there that can get by without sacrificing excessive amounts of time to medical school studies.
Depends on three things:
1. How you define excessive
2. How comfortable you are doing family practice/peds many miles from the sea
3. How naturally brilliant you are
I go to a decent but not top 10 med school and most folks I know work incredibly hard. Personally, I work a
lot harder than I did in undergrad. I usually work late into the night most weeknights and one weekend I work, the next weekend I try to take off. I stll have time to go running, but that's about it for hobbies.
I go to a pass/fail school. The problem with just doing barely enough is that you'll end up not learning the material well and get ho-hum board scores. If you want to do an uncompetitive residency in an undesirable location, this is not a problem. If you want to do even a moderately competitive residency in a decent town, this can spell trouble.
I'd guage myself somewhere in the middle of the pack in terms of intelligence. There are some brilliant minds at my school who could probably coast a bit, but most of these minds are attached to great work ethics and they put in hard hours. Med school material is not hard, there's just a lot of volume.
Folks who want to cruise through med school will either have a rude awakening or somewhat limited career options.
Do you just get by and have more fun in life or do you use your talents to really achieve highly?
You will have to work far more hours than a 9-to-5 job just to get by. You will still have fun in life, but it's going to be in more limited doses than before.
Many premeds do not take the time to really enjoy themselves in undergrad, which is a crime in my book. It truly is the best opportunity of your life to have a good time, especially if you're going down a medicine path. Med school is definitely not going to be the place you can coast.