With a score of 42 on the MCAT, yes. Less than 50 students out of an average 25,000 test takers of the April MCAT each year score above 40. Hopefully admissions committees will ask themselves how bad that 3.46 really is if you are capable of getting a 42 on the MCAT. Your experience as an EMT, volunteer work, and research nicely round out your application. If I were you I would apply to several top schools, but several “safety” (as much as that term even applies in med school applications…) schools also. Applying early can also help your chances. You may not get into every top 50 school you apply to – few people do – but you’ll have several interviews where you can stake your claim to a spot in their incoming class.