For derm, one of my classmates told me that the norm was around 100 (ie every derm program out there 😱 ). Plus they have to apply to a lot of prelim programs too if they want to be in the same area for prelim. Anyways, for internal medicine, US medical graduates usually apply to ~15 programs. If your a good student and you didn't only apply to top programs (eg Harvard, hopkins, etc), then I think that you will be fine. You should apply to 3-4 middle schools (schools around your level) plus 3-4 safety schools, then the rest can be reach schools (schools above your level of competititivity).