A lot of people make the mistake of thinking that if they have the highest grades and the hardest courses, that they will have the edge in admissions to highly competitive colleges. It seems to me that it’s more like there’s a threshold effect: are you in the top 5 or 10%? Have you taken the most rigorous classes? Mostly 5’s on your AP’s, good test scores? OK, then we’ll review your application seriously. What else you got?
It also can be a strategic mistake to think that getting into a top-ranked school increases your chances at med school. You are better off being at the top of your class at your safety than in the middle of the class at Harvard, or whatever your reach school happens to be. And that safety may give you merit money, decreasing the overall costs. A friend 's nephews are in exactly that position - one went to Princeton, didn’t get great grades, and can’t get into med school. The other went to a safety and had no trouble getting into med school.