http://www.newgrounds.com/portal/view/550648

The tactic that the legit players are using is to let the whole screen fill with monsters then clear it, and it should get you all three medals. You can use speedhack 0.1 to effectively pause it once it is full.

A loss is triggered like in Tetris where the block lands OUTSIDE the screen, so you can let it fill up to the top.

An additional 100 pt medal has been added for getting to Level 35. Damn people bragging about their scores in the help thread... Hopefully it gets removed/modified.

I would advise against using an AoB swap to get this new medal, since you won't obtain the corresponding high score and could be found out as a hacker. Only 5 people have the medal so far.

Would it be possible to control what types of things spawn? That could be used to get the medal pretty easily.

Only 5 people have the medal so far.

Correction: 5 people have hit the maximum score shown by NG Scoreboard; no one has achieved this medal as of yet.

Don't swap it if you want to keep your ranking list position.

Alright well a few people have this medal so I attempted to do it legit, it isn't terribly difficult actually. Wait for the screen to fill up, pick a type and roll with it, destroying everything but that type until you have ~40 on screen. (its a 100 square screen)