I have seen two generally different approaches to the application process:
1) The sawed-off shotgun method: Go for maximum spread baby. Write a super-general essay(s) and send it to everybody that you can afford to do so. Maybe you'll say something that will resignate (Bush-ism) with some adcom somewhere (after all a med school is a med school and they all look for about the same things right?)
Pros:
-Maximum exposure for the effort
Cons:
-Necessitates generalization in the essays.
-TONS of essays to complete when secondaries come around.
-The potential to get snowed under with applications, deadlines, interviews (granted, some argue that this is what the process is all about).
-THE COST!!
2) The laser beamer method: Apply to only a few schools with whom you have had multiple contacts in person, by phone, or email. You have spoken at length with admissions officers there, you know what the school is about, you know exactly what their emphasis is in education, you know what qualifications they consider important, you have determined that you have what they are looking for and know exactly what to emphasize in you application. You have asked the question: "what do I need to do in the next year (six months, two weeks...) to make myself the most competitive candidate I can be," and LISTEN to the answer and TAKE their advice. You have determined that you are in the demographic that they actively seek (in-state resident, primary care focus, URM, "Believe" in the Osteopathic Philosophy, whatever...)
Pros:
-Dramatically reduced cost for applying.
-You know all of the "buttons" that need pushing during essays, interviews etc...
-You know the school very well and can spend your time explaining why you are a perfect fit for them and they are for you.
-Fewer applications to fill out, your emphasis can continue to be quality and focus, rather than quantity and generalization.
Cons:
-The paranoid feeling that applying to more schools is always better (SOMEONE must want me!!!)
-The possibility that you were correct thinking the aformentioned thoughts.
You can choose one or the other, or some combination based on your values and the sort of experience you expect.
I chose option 2. I applied to 3 schools, all public and in-state, I knew what they were about, spoke to people, etc... I had no trouble meeting deadlines because I wasn't filling out dozens of apps. I told my first choice school that they indeed were my first choice right away. They interviewed me soon in the process (9/26) and I was gleefully awarded an acceptance (dated 10/7). As a result, I didn't even bother with the secondaries from the other two schools. Process over, and over early (yahoo!).
Just thought I'd relay that to all of you about to start this whole process for yourself. There were times I swore I could digest a box of nails with all the excess stomach acid I was producing, so I'm glad it is over, and I wish those who are still waiting all the best. Hang in there!