having recently completed an academic comeback of epic proportions, i'd love to lend some advice. i finished undergrad in march of 2000 with a 2.6 gpa, a blood alcohol level of .22, and about 5,000 disreputable stories.....yet last week i was accepted at a top 20 med school (and two other ranked schools). i'm not sure how much work you need to do to complete undergrad, but i'll assume you need all of the scientific pre-reqs. you will certainly be best served by talking with a) a pre-med advisor and b) the dean of admissions at the med school you really want to go to. i think that the most important thing you can do as an older applicant starting over again is to relentlessly target one place. i would go to either one of your state schools or a private school you like and make it clear to them that you are going to bust your ass for THEM. you must remember that the admissions committees are just a bunch of dudes and chicks trying to pare down a stack of papers. make yourself into a person they know and like. clearly your er experience and the fact you're willing to go back to school with the intent of becoming a med student will be sufficient to prove you are committed. it will then become necessary for you to prove you are both capable of handling the material and hard-working enough to push through all of it. take all of the classes they tell you to, do well in them, and get to know the teachers enough to get good letters of recommendation. my experience has taught me that medical schools regard letters from their own faculty and/or undergraduate faculty much more highly than those from outside sources. also anything you can get from thier alumni helps a lot. i'd see if any of the er docs you've been around are willing to hook you up. of course you'll need to do as well as anyone else on your mcat, so judging from what i've seen on this site a 28 should do nicely. i had to do better than that myself, but then again i was a serious **** up as an undergrad (sooo much fun). in my case it required 40 hours of graduate work at a 3.9 clip and a 32 mcat, but i think your personal tragedy would weigh heavily when the admissions committee considers your app. it's hard to say what numbers you would need based on the upward trend each year in the averages. if you can keep a part-time job in the clinical arena while you work through school it would help, too. i'm getting sick of writing......good luck!