I agree that mission is huge at a lot of places, especially Ventura. I can't tell you what it takes to match there (as I don't have any plans to go there), but I can tell you how to get an interview. Above national average board scores + honors on a couple clerkships at least, some research, some ECs in the community, fantastic LORs and ,specifically for ventura, a passion for full spectrum FM. Honestly, if you do the above (the last point is optional), you should be invited to every program you apply to. Oh and also, I think Med school prestige matters a little. When I interviewed at these "top programs", there were a lot of applicants from top tier Med schools.