The match is funny. I was sure I was a lock at one of my top 3. I matched #4. I spent so much time agonizing over those top 3 it wasn't even funny. I moved halfway across the country and knew exactly one person. And it was awesome.
Residency is only 3 years. It is temporary. You can go ANYWHERE to practice, but don't cut yourself off from possibilities at the risk of not matching... Rank your close programs first, but do interview elsewhere. The match is unpredictable at best.
I know my home IM program more or less guarantees we'll match if we apply there ("unless you kill one of the PD's children" is what they always say). Still, the school won't sponsor us for the match unless we apply to a certain number of programs (3? 4?). Not too sure.
The thing is what would you do if you didn't match? Would you scramble, or reapply the next year? If you would scramble, then why not apply to more programs, hope hope hope you match at your preferred one, but then have reasonable back-up (more reasonable than scrambling anyway).
I went to med school and residency at the same school in which I finished undergrad. There are many plusses to staying in the same town. (I know the hospitals, I know the attendings and the consults, my family is here, I already own a house, etc.)
I applied to several med schools, but opted out as soon as I got my local school's acceptance. I only applied to one residency. I remember telling them that if they didn't take me I would be unemployed. LOL!! Needless to say, I got in, and had no trouble finishing. Now I practice in the same town, and I love it.
There is a bit of risk involved, but if that is what works for your family, then by all means--do it!
And when they carve my stone, all they need to write on it is, "Once lived a man who got all he ever wanted..." --Ty Herndon