Not really sure tbh. I don't have a ton of shadowing/clinical volunteering. My ECs are more geared towards teaching, tutoring, etc., but I've been very upfront about all of that, and why would I get an interview if that's a deal breaker? Maybe I haven't adequately expressed a desire to return to NJ and they're thinking I might not want to go back for med school. Maybe I interview poorly. Maybe my offbeat, self-deprecating humor doesn't work in short bursts. Maybe the large amount of variation in my grades paints a negative narrative. Maybe they don't like my ECs because they're dominated by a fraternity. Maybe I come off as overly awkward. Maybe I didn't smile enough. Maybe I don't come off as passionate enough.
It's hard to tell. You can find plenty of reasons not to like my application. Pick the one you like the most, I guess. I know that's what I'll be doing.