I like academic medicine and want to publish in med school, I just don't have a substantial amount of research experience. I'm also trying to figure out where I'd br happy. The match lists always have family docs and internal medicine. A lot of schools in my list are reaches especially w just a 34 but I have a ones that match my stats and are likely to accept since I'm a state resident (I'm applying to every Ohio school). Should I apply to more mid-tier schools outside my state? How else would you fix this list?
My suggestion for your school list is this:
Given your wish to pursue primary care, it really DOESN'T make sense that you're going after research giants. Many medical students, I'm certain, don't have publications when they end medical school even though they've done research. Going to a big university won't guarantee that you get publications.
However, applying a little more broadly and considering schools that value research and are more in line with your primary care goals might net you some scholarships, which would make it easier for you to go do research at one of these institutions over the summer, even if it requires travel, as well as make your life easier in terms of, well, funding it. Even if you choose to do research at your school, many students from schools that aren't research giants publish. At my undergraduate school, my PI published two papers in Nature within four years of each other, yet my PI at Harvard now sometimes has trouble publishing.
There's no way to predict this sort of thing, but applying to a few more schools, particularly ones that have solid research but more middling stat levels, might be a good idea. However, as you mentioned, you're likely to get into your Ohio state schools, which will likely be your cheapest option anyway, so consider that advice with a grain of salt.