You don't have to be in the top of your class to match into a good PM&R residency; the answers to all your other questions is "yes." PM&R is a great match for DO's because the field is very open to using OMT. You will actually find that your manual medicine skills will be viewed as an asset by virtually all PM&R programs---I mean we're talking "physical medicine" here people! Most top PM&R programs have manual medicine workshops and tutorials for their residents as a required part of their training. So many therapists incorporate manual medicine of some kind or another into their practice that its becomes crucial that physiatrists understand these modalities first hand. Congratualations on your acceptance and interest in PM&R. It's a little known field to most students but a very interesting one. With the promising advances in functional restoration, the future for rehabilitation medicine is a bright one.