Dr. Cuts, I wouldn't recommend the option of not ranking some programs, and opting for the scramble. I'm currently an intern going into PMR (will start my PGY-2 in July this year), and didn't rank enough prelim programs, and ended up having to scramble for one. I was looking initially for a prelim Medicine spot in Chicago, but there were none available, and so I started calling up programs around the country....the medicine spots in California were all gone, and also in Seattle. I started considering other locations like Vegas, etc, with the idea of having a "fun" intern year, but found out from a friend of mine in the program that call was often q3...I ended up taking a prelim spot in pediatrics in California for the location (after 6 hours of making phone calls....a couple of people had to come back for the second day of scramble because they didn't find anything), but to make a long story short, the scramble was extremely risky, and you have to be very aggressive in trying to find a position early before the "good" spots get taken up....lots of PD's are on the phone lines talking to other candidates, and so often, the lines are busy....it was a scary situation to be in.
Just remember that if you're going for a scramble, you'll likely end up in a situation where you'll have little control over your locale, and you might end up in a program with a brutal intern schedule....another friend of mine was also scrambling, and he wanted to be in So Cal so much, he ended up having to do a year of Surgery....I talk to him every once in a while now during our intern year, and he's now working his butt off with hardly any time to enjoy being in So Cal.
If we could go back in time, we would have prefered interviewing and ranking more prelim programs. I know it's just a year...but it'll be the most brutal year of your life. If you have more programs that you could still rank that don't have brutal schedules, and are in a decent location for you to live in, I'd definitely rank them.
Good luck to you all in the Match!
