Please offer me some advice

[DangerRoss]

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[Catalystik]

My cGPA and sGPA are >3.9 and my MCAT score is >36.
I am a nontrad working fulltime with typical ECs:
Tutoring: 1 summer
TAship: 1 year
Research: 1 year (1 semester biomedical, 1 semester engineering)
Clinical volunteering: 150 hours
Shadowing: 60 hours
Besides these, I did a study abroad program during one summer and few other summer jobs. I also took a medical mission trip one summer.

Q1) What do you think I'm lacking most to be competitive for top 20 medical schools? I'm trying to do a) more clinical research in the area of my research interest and b) more volunteer work. Do you think doing these would reasonably increase my chances?
Q2) Given that I have 150 hours of clinical experiences, do you think doing some non-clinical volunteer work would be better than doing more of hospital volunteering?
Q3) Would you please recommend some good leadership activities that I can participate in (given that I already graduated from college now)?
Q4) I don't have much of leadership experiences besides my tutoring and TAship from my undergraduate years. But at the company I'm working for, I'm holding a lead engineering role within my team. Do you think this would at least partly make up for the lack of my leadership activities? Thanks in advance!

1) I'm not seeing any Leadership roles. And your Research is on the light side and split between two venues. Also, I would hope that you included an entry on leisuretime (Hobbies, sports, Arts involvement) activites to help your application stand out from the vast sea of similar applications. a) Yes. b) Some nonmedical community service helping the poor would be nice to see. Letting schools know about improvements to your application via update letters, (where permitted) can reasonably be said to improve your chances where adcoms are on the cusp about your application.

2) Yes.

3) Organize other TAs or tutors. Train new employees at work. (What is your work, BTW?) Start an organization and do something important with it, make it grow, leave the group healthy enough to survive without you when you leave. Take on the planning of a fund-raising event. Direct a play or other performance. Be captain of a sports team. But ideally, you'd take on a leadership role with a community service organization, like chairing a committee for Habitat for Humanity, or somesuch, and do good with the position.

4) Yes. How much it would help you would depend on how leadership-y the role was.

Tutoring and TA are looked on more as Teaching, though it is possible to so dominate the experience as to have it scream "leadership." But your description of the activity would have to support that.


Postscript: I see that I should have read all the questions before beginning to answer them, as it's clear you have already appreciated most of the weaknesses that might keep "Top Schools" from finding your application appealing.