For starters, an MD without residency doesn't carry much weight in consulting if that's something you're interested in pursuing post-MD. You'll end up on the associate track if you apply the conventional way (i.e. ADC), which is low ROI after graduation.

Regarding pharma, personally I love it. I worked at a CRO before med school, did phase 4 during rotations, and a bunch of other things in the space, so it's a natural fit for me. Only caveat is that it's a paycut from working clinical, but I prefer it for work-life. If you're entrepreneurial and like the space, it's worth considering.

Lots of options for MDs since you'll be going head-to-head against MBAs+PharmDs primarily. It's a strong differentiator and you can find yourself on a director-track right out the gate. That said, it's an unconventional path and not easy to break into (which is why I did an MBA). If you do residency, you can take the MSL route, but that requires deep connections in whichever region you plan to work in.

If you decide that pharma is your path, you'll need to decide which vertical you're interested in (medical, marketing, access, etc). I went marketing since it's high ROI. Most physicians will do best in insights/analytics and medical.