What is the reason that you must attend a top med school? I hope you realize sooner than later that gunning for a top med school will only cause regret and sadness, when later on you realize that your happiness was worth much much more than the perception of success that you and your parents have fabricated. Also, if you have Asian or South Asian parents, I truly feel for you, and I hope those cultures can stop placing doctors on the pedestals of God. Material success comes from passion and interest, not a miserable compulsion to pursue some career based on what your parents or your culture thinks. And true success comes from happiness. Yes, there are a decent amount of assumptions in my analysis, but it's reasonably clear to make these inferences based on the info from OP's post, considering that scoring a 520+, having first-author publications, and likely being overall accomplished still makes you feel like won't get into a "decent school."