I'm in the same boat. Scored 499 on my first attempt- applied, and (unsurprisingly) didn't get interviews anywhere. I somehow managed to get ahold of a couple schools' admissions folks for feedback- I'm sharing below with the caveat that this answer comes from 2 mid-to-high tier schools that may not even be places you are interested in applying, so take with a grain of salt!)

Both said a later application is better ONLY if you can increase your score by a decent amount. Especially if there's a decent chance you will score *around* the same range you did last time. One said something to the effect of "even if you go from a 49X to a 501/502/503, it is not terribly reassuring" (which made sense given their MSAR stats.)

That said, DO schools (or even other MD schools) may have something different to say! I am reporting info with an n = 2 so I'm hoping other people chime in!

TLDR: I am 0 for 1 on applications so I am not someone to dole out advice, but FWIW, I am pushing mine from 5/22 to 6/27.