I assume you actually mean "very competitive program" instead of simply "ivy" (these two terms are not synonymous). If you are aiming for a top tier program, especially in IM, you will have a lot of trouble matching even with very strong stats. Sadly, DOs don't just get into IM at MGH or Hopkins with a 270 Step 1 and a few first author research publications. Historically, it doesn't happen. You're competing with people with academic pedigree (students coming from top tier MD schools, schools with whom the top tier IM programs have a good understanding of due to accepting students from there for decades and decades). If you want to get to the top, you need strong mentorship and/or connections with someone influential in the field. If not, forget about it and save your money.
The rare examples of DOs matching into very competitive programs most likely had research under very notable PIs, who then simply wrote letters or made calls for them.
Keep in mind also that the fellowship bias against DOs is far less prevalent than residency bias against DOs. Massachusetts Eye and Ear Infirmary (Harvard Medical School) took two DOs this year for ophthalmic fellowships, which is impressive for sure -but their residency program has a history of taking only well-connected students with strong research and/or academic pedigree for their residency program.