Calc used to be on the PCAT (and may still be), so the situation is a bit different for pre-pharm students. Pharmacy is also a lot more mathematical than medicine is. Anyone who is pre-pharm should probably take calc. For pre-med, it depends. A few schools do require it. If you want to attend one of those schools, you will need to take it prior to matriculation. Likewise, if you're going into medical research (MD/PhD or MD/MS programs), you should probably take it. Otherwise, trig should be sufficient math background for the MCAT and med school. And I would argue that biostats is a much more useful math class for the average future clinician than calculus is. So if you're only able to take one math class as a premed, go with biostats.