Ivy League vs. REMS?

It all dependence on your risk-taking appetite. Can you risk bird-at-hand (REMS) ? Are you confident that you can get a UG GPA >= 3.8 in your Ivy alternative (HYPSM tier). Without any other information provided, there not much to make any suggestions. Is it one of the HYPSM school ? They all are very competitive and can affect your UG GPA. Being a UG from Ivy will not give you any browny points for regular route MD. Are you committed to become a MD ?