Lack of Clinical Experience for last 3 years, but lots of other clinical experience. Gap year or no?

Prior to returning to school three years ago, I worked in clinical mental health and accrued close to 2,000 hours of clinical experience (and is a huge reason why I’m pursuing this path) - great, yay. Being money conscious, my number one priority going back to school was to graduate undergrad debt free - with that said I chose a community college for the last three years, but it is in a rural area where clinical experience opportunities are lacking.

I volunteered in the ER in 2017 for 40 hours and quit due to the fact they didn’t want volunteers doing anything except handing out blankets and cleaning rooms with no patients in them. I have other volunteer service with athletics and animal shelters, but nothing with patients except that 40 hours…but around here there is only the hospital and nothing else.

I plan on getting my EMT license this summer, along with studying for the MCAT and am shooting for a 515+. I am transferring to a four year in a larger city for fall (to use my EMT license) and want to apply next year 2021. Are there ways to explain on AMCAS that my lack of clinical experience last three years was due to lack of opportunity being in a rural area? Does my 2,000 hours plus whatever I get with my EMT count as more than enough? Should I consider taking a gap year?

I’ve always heard school prefer consistency rather than hours, and just needed to vent about this. My cGPA is 3.65 with an upward trend of 4.0 for last 60 semester credit hours and a sGPA of 3.97 if this helps or not with determining a gap year. Also, is it too ambitious to try and do EMT course and get a 515+ on the MCAT?