Also, from Philly here... My wife went to PCOM in the end... And is now finishing residency at Einstein. Drexel, Penn, both did not even interview her... Temple did, I think, but did not accept her...
I guess it can be tough, and unfortunately now, I feel like the lucky one.
For us it was tough with Fellowship though... My wife was destined for Hem/Onc... devoting ALL of her extra time and electives to it. She worked at Fox Chase for 3 years before Med School, won the Einstein award for Oncology in her intern year, managed to score recommendations from top Oncologists at Fox Chase, Einstein, and Jeff, she was published for her research work at Fox Chase like 10 times in journals, and she's hot (even though that doesn't matter)... There were not that many options in the area for the fellowship, but we were hoping for Fox Chase or Jeff... but no go. So she gave it up...
For us it was more important not to move too far away. If the only place she was accepted to Med School was in Erie (which she turned down), she said she was not going to go anyway (we were not married at that time)... and if she did, I probably would have went with her.