I applied to 60+ programs being a weaker candidate (step 1 in the 200s but from a name brand med school) and also doing the couples match (partner not in IM, but with a much stronger app and step scores 30-50 points higher than mine, haha). I've received 21 interviews (mostly community, 5-6 university), 6-8 rejections, and also haven't heard from the vast majority of them.
We applied to Boston, NYC, Chicago, Philly, DC, NorCal, SoCal very broadly (I would apply to a good mix of 4-5 programs in each place), and we also applied to a bunch of smaller cities where it was more like if I don't get into the university program we won't really consider the city (Emory is a good example for Atlanta...this is mainly because although I'm ok with community programs, I don't want it to be any random community hospital just for the location).
So far, we have had overlaps (some with 2-3 interviews) at NYC, Chicago, Philly, and NorCal. But it's been fairly hard at the smaller cities. A lot of the "mid-tier universities" (GWU, Maryland, Tufts, BU, USC...etc.) really haven't been panning out for me. I'm OK with community programs, but I (and my adviser) are surprised at the difficulty this year. I thought I was over-applying in September, but now I feel like I'm barely getting to the sweet overlap spot.
We've emailed a bunch of PDs recently...nothing has really worked except this one really nice PD at a community program is going to interview me just for the sake of my SO getting the university program invite next door. We'll see how it goes.