finnto, I don't disagree that contextual offers are hard to come by. However Bristol is an exception to the rule, as they consider such offers routinely for anyone coming from their list of the 40% lowest achieving schools. Which may explain why they have so many applications. There are some others that will consider applications from students with predicted AAB, but will offer at AAA.
Obviously the advice has to be to try to do as well as possible on each of the potential criteria. Get the volunteering/shadowing in, even if it is volunteering in the local old folks home. DDs advice is to nail the chemistry A level. People will get in with dropped grades, but rarely chemistry. My advice is to practice UKCAT, especially timings, as much as you can. Being on the 80th percentile rather than the 70th, say, makes a huge difference in where you can apply. And practice really helps.
Then, again, apply strategically, and if your application is not the strongest, treat the Yr13 application as a trial run and don't allow it to distract you from getting the best A level results possible. Being a doctor is not just academics, though obviously you need a certain level to avoid struggling through the course. The NHS is calling out for good sensible GPs, just as much as they want cancer researchers.
And Pixel, yes Bristol is working out well. As you might expect from somewhere which puts emphasis on the PS, there is a real diversity of students, who are slowly bonding into a good group. Bristol has a "rah" reputation but this does not seem to apply at all to the medics, and DD is also finding herself surrounded by northerners in her sports team. Good as she had wanted to move beyond the London private school bubble she grew up in. (They all grow up in their own bubbles!) She has found the pace pretty gentle to start with, but perhaps that is to help ease in those who had less training in study skills. I would be surprised if the eventual correlation between A level results achieved and final performance is that strong. Things are hotting up and there is a huge amount of material to learn. She is finding the course really interesting, and likes the early exposure to patients. Bristol itself is beautiful, and there are lots of University as well as medic things to get involved with. There is some conflict between the life styles of science and humanities students in halls (medics have 30 hours per week compulsory contact time with four 9.00am starts), but this will solve itself in the second year, and presumably common where medical schools are in University settings.