If you guys wanna stay true to yourself and be real about your future goals, I can respect that. If you have lots of interviews, you can afford to be choosy. However, it doesn't make sense to me to accept an interview and spend the money/time/energy to interview at a program and tell them about your fellowship goals if you knew from before they are not fellowship/research-oriented and prefer producing general internists as graduates. If you applied there as backup, why not just lie about your future goals there so they can remain as your backup. Otherwise, they will rank you low on their ROL or maybe even put you on their DNR list because you're not a good fit for them, and then you just wasted time/money/energy interviewing there. If you learned about the program's preferences/limitations afterward during the interview day, that's a different story of course, we don't always know what a program is looking for until it's too late.
If a program isn't a good fit for you and you don't want them even as your backup, and would rather reapply next year than end up at that program, don't rank them lol. But as long as you're planning on ranking a program as a backup, you need to maximize your chances of matching there (which includes lying about your goals, lying is maybe not the most gentle of a word to use, how about not emphasizing your interest in becoming an interventional-structural-vascular cardiologist.)
Also, just because a program doesn't like applicants who want to subspecialize doesn't automatically mean you have to kiss your fellowship good-bye if you match there. You can lie about your future goals, match there, then work hard for that fellowship, grab whatever research opportunities you can find, publish some case-reports, present and network at conferences, try to find subspecialty mentors at the hospital etc. The Wright Center for ex. only has a PC track for IM and is looking for applicants interested in IM primary care, but they have like 3-4 in-house fellowships and their IM-PC residents are matching in those subspecialties.
Unfortunately, the match is tough, some of us are having very few interviews, we know we're worth more than what we're getting, but when there's no better option on the table, you grab what you can get, you take option#1 because there is no option#2.