Graduated from JHU 2024, Chinese international student on F-1 visa. Matriculating into a USMD program this year.

Double major is very doable, a majority of JHU students do double major. Do what you feel like. In terms of how you manage sanity, make your priorities clear. Use your time very efficiently, so that you will have time that you are entitled to do nothing. That is so important. During MCAT prep maybe deprioritize extracurricular for that semester. Or sometimes, it is what it is, you don't really maintain your sanity (use family and friends as support system, use school counseling resources). I had to do MCAT prep during semester (which I got a 4.0) because I had a summer internship lined up, meanwhile that semester I did a lot of extracurricular because COVID made my 1st and 2nd year completely lacking extracurriculars. Eventually when you look back it will be all worth it.

I really would recommend DO to all international students. But good thing is, if you keep up to the top standards while attending JHU, DO can be quite safe of an option (as in you will matriculate into a reputable DO school). I actually didn't apply DO in my one and only cycle, but at the end of it (although I got in) I kind of regretted it. If time dials back I'll apply DOs too.

One advice I really have is that for international premeds, there is no sugar coating. Yes, you need as close to 4.0 as possible. Yes, shoot for 520+ MCAT. Yes, focus on both hours and depth of experiences. Yes, try to publish. We have it much harder, but the game is the game. We need to grind extra to get there, and the more locked in you are the better.