很优秀孩子，competitive, but not compelling

Must come from a small state. In large states, there are more US presidential scholar semi finalists. 全国赛事, the value depends on what the 赛事 is. Class rank #1 is good, but this is also from a very small class (<100).

Other than that, I don't see any unique shining points beyond a typical  学习优秀的小中.

But Harvard waitlist means something. It's not easy even to get H WL.  If he/she applied ED for little ivies or alike, he/she should have much higher chance to get in  (usually with a H WL, a student typically would also get a few little ivy offers at RD round)

But the state MD/Ph.D program should work out well if he/she is set on the MD path. BTW, there is still chance to get off the WL, especially from little-ivy level schools.