Deciding where to apply
Serious research is required when putting together the list of schools to which you will apply. The most critical issue is that of state residency.
State-supported medical schools will give strong preference to individuals from that state. Some, in fact, do not accept any out-of-state applicants. Students, therefore, should first consider applying to schools in their home state which give preference to in-state residents and avoid applying to schools from other states which accept few if any non-residents (see the Medical School Admissions Requirements book for this data).
This leaves the private medical schools and state-supported schools, which do accept a reasonable number of out-of-state students. Examine the ratio of applicants to entrants at various schools, as some are better than others. For example, Boston University enrolls a reasonable number of out-of-state students (89 in a recent year). Yet they had 9,858 applicants, for a ratio of less than 1%.
Virtually all private schools receive a huge number of applications due to their openness to non-residents. This makes them extremely competitive, as you will see from the applicant/enrollment ratios. However, take heart — they will need to accept more people than they actually enroll in order to fill their classes, as some individuals who are admitted will go to other schools. While this improves the ratios a bit, it still is very competitive.
Due to the extreme competitiveness of the whole process (there is no such thing as a safety school), it is advisable to apply to a large number of schools (at least 12 to 14 is a reasonable number).
Other factors to consider include the emphasis of the school (some are geared toward academic medicine and research, others toward primary care, etc.), cost, geographic location, prestige (ranking) and curriculum (see the AAMC Curriculum Directory and read the school catalog).