If you have applied 2 cycles already with your MCAT, don't forget it's about to expire. Most schools don't accept 3+ year old MCATs. With that said, you talk about wanting to keep doors open by rejecting DO because you want MD, but at this pace, you're only going to close more doors as you go. Don't forget, every time you reapply to those MD schools, it's only getting harder to get in unless you show significant enough improvement (meaning a couple hundred more hours of ECs ain't gonna cut it, meaning you probably need 1 gap year). Every year, some DO students end up matching Derm, Ortho, ENT, Ophto, and other competitive residencies (though they are the minorities), and going MD doesn't guarantee you any of those spots either. What I wanna tell you is, you do the best of what you get. If you want Derm, and you go to a DO school, you just gotta make damn sure you're competitive for Derm for the match, just like you would have at an MD school. That's what any DO students that match any of the competitive specialities do.