Hi there, just wanted to add my opinion!
I agree with Lee in that the MCAT score is likely the culprit, though some of her experiences may also be lacking. Ordinarily that wouldn't present too much of a problem, but overall it is definitely a weaker application. The fact that she did well in her post-bacc/SMP is reassuring, but the rest of her app not so much. Here are the things she needs to address:
1. The MCAT. Her MCAT scores are both below 50th percentile, and she actually went down during her second MCAT. If she wants to re-take the MCAT, she absolutely positively has to improve by several points. A third MCAT in the same range would be a death knell. The MCAT is a hard exam and for some people not something that they are able to study for while working even part time. Your friend needs to understand that in order to be a successful medical school applicant, she needs to do well on her MCAT. If that means not working at all and studying full time for several months, then that's the route she needs to take. If that is not possible with her current financial situation, I would advise NOT taking the MCAT a third time in January and instead working full time and trying to save up enough money to be able to not work for at least 2 months. Doing this half-way has seemed to not need to work for her twice, and a third poor attempt means she probably will never go to medical school. Medical schools are not going anywhere and so if her timeline is extended even by a year or two because of this, it would be infinitely preferable to the alternative, as long as her ultimate goal here is becoming a doctor.
2. Her experiences are a little lackluster. As I said before, with a strong GPA/MCAT combination, they would be borderline acceptable, but 50 hours of clinical experience is well below the average (100+ is what I recommend minimum, but many applicants have more than that). This needs to be active, participatory experience, not shadowing (which is important too, but she has an adequate amount of shadowing). EMT shadowing doesn't hold much weight (actually being an EMT would, but shadowing doesn't) and I wouldn't even list jury duty on her application. The Guatemala service trip will likely be looked at neutrally. If you put all that together, she doesn't have a strong non-academic profile, which is not doing her any favors. This is still secondary to the MCAT, but it is something she will need to address eventually. The clinical experience does not need to be volunteer experience. She can work as a scribe, or an EMT, or a patient care tech, or a nursing aide, or anything like that as long as she's working with patients. Medical schools understand that people have to work to make a living, but they also need to know that you are motivated by service to others and know what you're getting into.
3. The fact that she did well in her post-bacc is reassuring, and she likely will not have to take any more classes to augment her GPA as long as she does well on her next MCAT retake and addresses her extracurriculars.
4. She should really be applying to every DO school in the country. She is not the type of applicant that can afford to be picky when it comes to schools.
So in order of priority #1 is taking the MCAT and doing well on it (preferably after 2 months of full time studying and multiple practice exam scores above 500), #2 is expanding her extracurricular profile, and #3 is choosing a more appropriate school list.
I want to reiterate this one more time because in my opinion it is a life or death difference for her application but she should not take the MCAT again without demonstrable evidence that her score will improve (which to me means multiple practice exams above 500).
Happy to answer any questions. Your friend is in a tight spot, but not one that can't be navigated and overcome. I wish her only the best of luck in this process.
