Try to get as high on the MCAT as possible (especially the BS section). Don't just try to get the 507. Go for the established MD school preferably your state school if possible. (For the MCAT studying (wish I knew this ahead of time), the AAMC materials are best; the real exam will be the same ideas (in very rare circumstances even the same A-D choices) or a similar concept (highest yield are SB, official guide, free practice, and FLs, but it will be presented in a different context - drawings vs explanations). Know all the explanations for the wrong choices not only in AAMC context for that particular problem (not just memorizing their answers), but go deeper because it will be tested in a different contexts. Very rarely, it will be the exact same context. DO will be fine if you are a medium to top student and you are not as selective about location. However, if you are on the bottom or lower areas will some red flags, it can be problematic. There are more barriers and some of them are increasing being formalized via Step 1 changes and residency changes.
Previously, DO had the advantage of AOA residencies (even if you were a poor student, you are only competing against each other because the top DO students are aiming university MD residencies). This year's match shows other people besides DOs are applying and filling previously DO positions. If current trends hold, it suggests they want the best students regardless where they come from. IMGs did not go down as I originally expected; if the trend holds, it will be more pain for weaker US students.
I just had a friend who is a graduating DO that did not match this year (He had the dual disadvantage of I believe repeating a year and being in a location that is over-saturated with medical schools). He is among the 9% of DOs that did not match this year and I am hoping he gets into a SOAP spot. (
New! Press Release: Thousands of Medical Students and Graduates Celebrate NRMP Match Results - The Match, National Resident Matching Program). It is a hellish situation to be in not matching. I took a brief look at match after learning his troubles.
I don't know why people are celebrating the 2020 match. To me, it looks terrible. The total surplus number of SOAP spots open this year minus the number of unmatched US MD/DO students is around 60+. I remember the late 90s when non-trad IMGs who are out of practice for many years could get university programs even without any support. Things are quite dangerous. (Of the 6 DO interviews that I attended, only a single school talked briefly about residency (their concerns and hopes); it became my top DO choice despite being a weaker program because they are serious about this issue, but I ultimately decided to withdrawal from their WL after they emailed me back asking if I was still interested in staying on the list (somewhat painful decision) because DO has fundamentally changed). There is like 2000 IMG that are US citizen (probably Caribbean people) and some non-US IMG also competing for the SOAP seats. Doing medicine through the MD/DO path is a noble intention, but you have to take responsibility and think it through carefully. This is not a game because it is your life on the line and you are dealing with six figures of debt and a 6% interest rate per year after graduation. Most of the faculty are interested in the paycheck and going home after getting their required stuff done; they are not going to bend backwards and super analyze you to ensure you are going to be matched especially if you are a weaker student.
Keep this in mind, I thought the residency shortage was going to be an issue in 2024. It is clear that it is a problem this year with many schools able to steal a seat out of their traditional rotational spots range because of strong Step 1 scores by their students. I don't know how schools will adjust to doing well on the Step 2 or how they will expand their range of affiliated hospitals when the competition becomes even fiercer. I assume the Caribbean (still terrible place to go) will be willing to open their wallets more because their entire business model fails if they can't get people matched. The worst outcome will be if this becomes a battle of resources and wills instead of having better students and serving local needs. You will always be in a strong position if you are in the lead group, but there is real danger and less forgiving if you are a weaker student. Good luck and talk it out with people who are knowledgeable and have only your best interests in mind.