First author on a paper published in a high impact journal (Nature, cell, the lancet, etc). Basically, you are actually the first author/primary researcher behind a meaningful scientific discovery.
As someone in the the low GPA high MCAT (3.4, 3.2, 35) boat who's gotten a few solid interviews, I would say having a TON of meaningful clinical and research hours that are interrelated. For me its been volunteering with patients that suffer from a given disease, working in a clinic that treats that disease, shadowing doctors that treat the disease, founding a non-profit that helps improve access to care for that same disease, and doing clinical research on the disease. Ive left the name of the disease out for anonymity, but you get the idea.
Much more straightforward route though would just be to do a serious SMP that has good linkages. Columbia and GTown come to mind. I have friends who didn't get accepted anywhere, killed their SMP, and are now at places like Hopkins and Columbia. In any case, best of luck!
I only view SMP's as last resort options ie your typical candidate the OP might talking about with a 3.4/34 should not be doing an SMP without at least going through an MD application cycle first and seeing how it shakes out. And even then, I would only recommend SMP consideration for those who would rather not be doctor's than DO's because as others have talked about SMP's are just brutally competitive.
Alot of people look at SMP's as some sort of "get out of jail free" card or magic pill and in reality aren't honest with themselves; there's a reason their GPA was mediocre in the first place. For many, magically flipping some switch isnt going to be enough for them to beat out the majority of first year medical students(many of whom had 3.75+/32+ stats) in those students classes where the MS1's unlike undergrad for many of them are going absolutely all in on doing as well as possible. And those are the standards for an SMP; beating out 35% of MS1's as an MS1 yourself is fine. You can overcome Passing grades in pre-clinical years and do rather well with your residency application with making other parts of your app strong. But if you are an SMP student and those are your grades? You're in big trouble.
To answer the OP's question here are things that can really help your generic 3.4/33 applicant who wants to take a couple years off to maximize their odds
a) Peace Corps
b) Americorps
c) Teach For America
d) Substantial involvement in service to the less fortunate. Think doing 12+ hours a week over 2 years and obtaining leadership type positions through this.
e) Substantial clinical experience. Doing something like working full time as a nursing assistant could qualify here.
f) Research. I put this down on the list because a) getting that top publishing record Goro is talking about is alot easier said than done and as a lab tech/research assistant it comes down to many things you can't control b) many many people do research during gap years. Unless you do something truly extraordinary it's just really hard to stand out via this avenue.
Also, it's rather possible to do some of these things while also taking some upper level science courses through a DIY post-bacc in the meantime. Even say 7-8 upper level science courses over the course of a couple semesters with a 3.75+ showing in them could definitely help your application even if the overall GPA boost is say only from 3.42 to 3.49 or something.
Note: this is all for maximizing your odds at
LOWER TIER and some medium tier schools. It's a usually fantasy world to try to gun for top 20 schools with a 3.3-3.5 unless there are some exceptional circumstances or you have a very very unique app. Even hitting those top 20 school median MCATs which are around 37 probably isn't enough. Tons of people with 3.9/35+ stats strike out from all the top 20 schools they apply to every single year. And doing an SMP to try to get into a top 20 school like others have said above is the definition of ignorant and irrational.
Just to highlight how foolish it is to use an SMP to aim for top tier programs take a look at Georgetown SMP alumni's list of schools they have ended up attending. And these lists are fairly updated, especially for 2011-13 even for those who wait a year or two to go to medical school after the SMP is finished. And keep in mind many would argue Georgetown is perhaps the top SMP program out there.
https://smp.georgetown.edu/alumni
2011: Einstein, USC, UCSD, Colorado, UVA, Vanderbilt
2012: Boston U, Case Western, Emory, USC, Florida
2013: Einstein, Brown, Case Western, Emory, USC, UNC, UVA
Count that, in 3 years what is that one top 20 school any Georgetown SMP graduate has gone to in Vanderbilt?
