WAMC

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I don't think it's unrealistic to include those reach schools. Some of them may be more reaches than other (mainly JHU and WashU who seem to really like high MCATs, like 520+). I had very similar stats to you (I had a slightly higher GPA, same MCAT), although I went to a state school (and honestly, you definitely get a bump from going to a T10 undergrad). I know a number of people with our stats who received T20 interviews. I applied to a number of those schools and received no interviews at them. It absolutely doesn't hurt to shoot your shot, as long as you have a solid list of targets/matches. I did best at those target schools, receiving six IIs, two of which actually had MCAT medians that were a number of points below a 517.

The T20 can be a bit of a crapshoot for everyone. I do notice that the 520+ applicants tend to get more love, but I know people with 517s who interviewed at places like HMS (although they didn't always get accepted). You won't know unless you try. Just make sure you have a good set of mid tier schools along with the high flyers.
 
I am starting to get more and more concerned that my MCAT score is too low to realistically think about top 20 schools, but my undergrad school approved my school list that included around 10-15 reach schools (along with 15 other targets/matches). Most of my reach schools are on the East Coast, including all 4 reaches in NYC (Columbia, NYU, Mt Sinai, Weill Cornell). I have 5 years of research, an honors thesis, 250+ community service hours including 150 in my field of interest in the opioid epidemic, which I'm hoping will be valuable and interesting for my application. Am I in over my head?
517 is not too low for top schools though you may not get first round interviews. Have you made efforts to connect with students and admissions staff at those schools?

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