A few thoughts
1) Where/why do you think that people who match in these ultra competitive specialties do so because of their record in undergrad? The only connection I can think is these people who outstanding UG records are in fact outstanding students is get into highly selective medical schools and do great work there. And there are applicants from state schools with solid but not outstanding records who also get to great residency
2) Applicants seem to have a belief that most undergrads in research must have a publication, presentation, or poster (PPP). While near 90% of applicants have laboratory and/or research experience, at max 20% have ANY form of PPP. This includes campus symposium, students groups, or small conferences/journals. Less than 5% have anything major as in significant journal or conference. And usually they are simply part of a team authorship. Very, very few have publication in major journals where it is their project or they are a lead author. And the few that I have seen are as much luck as anything else.
3) You need to focus on simply getting into medical school as that is the requirement for ANY residency
4) Every year I get applicants and their parents who say they ONLY want to be a neurosurgeon and they ONLY want to go to Harvard or JHU the others. And what I tell every applicant, if you arent ready to be a family practitioner in a midwest suburb, then maybe medicine isnt for you. Once you start medical school there is no guarantee you will get any particular specialty 4 years later.