Oh boy...I can now actually answer this question from the perspective of someone who recieved an appointment from Mayo Medical School (just got off the waitlist...don't worry Saluki I'm one of the 6 MSTPs). It is an incredibly difficult school to get into, honestly I was just honored that I got interviewed and stunned I got waitlisted...I still think the appointment may be a cruel joke...time will tell. The admit rate should speak for itself, but it shouldn't discourage you at all. Unlike some the schools that REQUIRE ridiculous numbers, Mayo seems to hand pick their class and really try and have a spectrum of people and personalities. From the folks I know (I've spent a summer working there...and my small midwestern LAC has a couple of kids at MMS right now) being from a big name school isn't an advantage...they treat people from top-tier LACs, Ivies and small state schools the same, and in some ways seem to almost prefer midwest kids with humble backgrounds. Also they want to educate people to keep in their system and that is why I think being from the midwest is an advantage at the school, Rochester isn't for everyone, but the clinic is one of the few truly special places in this country. As a previous poster said ~50% of MMS grads end up completing their residencies in the system, and over 20% of grads join the Mayo group practice once their residency is over. It is an uphill battle to get in for sure, but it is by no means impossible. Before you apply if you are serious I would definitely suggest taking a visit to see the place...its amazing.