Given that 50% of applicants will not be accepted, I think this is a good subject to discuss. If I'm not admitted, I plan to continue working in Epidemiology full-time while continuing to take courses toward an MPH. At my age (thirty something), I plan to only try one additional time. If not successful at that point, I'll continue on for a PhD in either Pathology (with an Epi focus) or Cancer Epidemiology. Getting a PhD won't be much of a stretch for me since I'll be applying to MD/PhD programs anyway.