This is unlikely to be well-received, but my impression is that, within top 20 schools, there are some who look for people who have high GPAs and high MCATs who send their applications early and follow rules, whereas there are others that want students who demonstrate individuality, excel in research, show musical or other artistic interests. Any school needs a mix of both, but my impression is that some schools just seem to prefer a balance shifted more toward one of these archetypes. I would put Vandy in the first category along with Michigan, Wash U, and Pitt; and places like Columbia, Yale, Stanford, Cornell in the second. I am leaving some places out, but maybe that just means they are more toward the center of the balance. This is obviously a simplification, but this is my impression from having gone through this cycle the past year.