On the one hand, it's "just" family med so don't sweat it.
On the other hand, the average # of apps for FM applicants is 63, per our PD last week or so. It used to be, like, 13, and you could rank 5 and do fine. Keep in mind that the only (ONLY) thing the Nobel-winning match algorithm claims to be is fair (FAIR), in allocating applicants who interview at and rank a list of programs, against programs who interview and rank a list of applicants. If 30% of FM applicants don't match, and you're in that 30%, regardless of your app assets, that's not unfair. It's math. Math is existentially and emotionally neutral. Borderline applicants routinely apply to 100+ programs because math. FM PDs are pulling their hair out over whether their programs will fill if they "only" interview their usual ~150 because the app pool is so massive and diluted with maybes who apply all over the country. My program did more interviews this year out of pure FUD (fear, uncertainty & doubt). No, you can't find out how many apps a particular program got, you can't find out the stats or other app tidbits of successful applicants, no you can't get any data to understand the difference between ranking high enough and just getting ranked.
What all that means, and why you should care, is that it's substantially more likely that a boring, generic app will get lost in the pile. If you have no red flags, yeah, you'll probably match, SOMEWHERE, if you apply to a lot of programs and go on a lot of interviews. But if there's nothing "sticky" about your app, such as REALLY INTERESTING MEDICAL/COMMUNITY ACTIVITIES such as free clinics, community orgs, teaching, pubs, nontrivial non-tourist overseas service, relevant 2nd/3rd languages, you're not in a good position. And if you are shy, awkward, inexperienced, not personable, maybe you remind people more of a current unmotivated resident than you remind them of a current great resident, etc, then you're getting ranked below somebody who is equally qualified but made a better impression.
Pretty much just like med school admissions, except that ranking is less certain than an acceptance or a waitlist position.
So. You're in your 20's, you're young and fabulous and want to do things other than take a position of responsibility during med school to increase your odds of getting one of your top ranks? Fine! Go backpacking in Europe and take easy electives. Really, there's no going back to relive your 20's, and an MD is forever (unless you are found guilty of sexual assault or similar and your degree is revoked, or what have you, google "case western medical degree revoked"). Match wherever, whenever, doing whatever. Down the road when you have a clearer idea of your mission in life, invest in that mission then instead of investing in a maybe now.
If you don't actually want to do community extra-curriculars in med school then I'm skeptical that you are actually interested in FM, but that's sort of a separate problem.
tl;dr: FM residency is a short 3 years and maybe it doesn't matter where you match but if you're going to resent not getting one of your top choices or top locations, then buy some insurance by legitimizing your application with relevant activities.
