Gap year or apply straight through?

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Lacking a bit in clinical experience. Unless you can do substantial shadowing or get clinical job experience over these next few months (which may be difficult since you're not only still in school, but also prepping for the MCAT), I'd suggest taking a year off to do so.
 
Med schools don't care about your high school hospital work. You've done 100 hours over 4 years. That's 25 hours/year. Most hospital volunteer programs have you do 200 hours in a year. Even though you've done 150 hours of shadowing, you're still a bit low overall.

I always encourage gap years even if you don't need improvement. You've been in school for 17 years, you're about to be in for 4 very taxing years, plus another 3-6 putting in long hours as a resident. If ever there was a time to take a step back and breathe for a few months, this is it.
 
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