I would put the previous #3 at No. 1 - I've said it before, at most all the programs I've seen, there is no better way to get in than to fit in and make the program want you. I was never asked about my grades or scores until interview day and I know of several examples of people below the famed 230/AOA who have gotten into good programs because they rotated there and did a good job. This doesn't go for all programs, because many get so many rotators that it doesn't mean that much to them - you should ask around to find out which ones these are and think hard about how much you want to rotate there, especially if your numbers are less than spectacular.

You forgot:

#8 Don't be an A-hole.

I know of enough guys who rocked boards, were AOA, and "knew all the right people" but were so full of themselves that nobody liked them. The lesson is work hard, don't complain, and be nice to everyone you work with.

AOA means very little (in terms of hurting you). If you have it, then it MIGHT help you. If you don't, not many people care. My med skool didn't even post AOA until after the match, as many med skools don't. The main thing is that you pull down a few honors in the "big-gun" rotations (i.e. med or surg) and avoid failing (or just passing) any clerkships during 3rd year.

I agree with the importance of "rocking your aways," not being a freak, and doing "well-enough" on Step I so that it's not an issue during interviews. What's that score? I have no idea, but I got a 228 and only one interviewer mentioned it (out of the 12 programs that I interviewed at 5 years ago).

I talk a lot with the Chairmen of our program and other staff members about what they look for in an applicant. On interview day, Most take a glance at the step 1 score (#1 by far). Then they peruse your LOR's to look for the "big names" or people THEY know. They look at your research/publications. They may or may not note what med skool you attended and how well you did in Surgery and Medicine. And quite a few of the attendings actually care what you do in your free time (that damn "hobbies" section). The rest of the time is spent weeding out the "pathologic" personalities during the sit-down interview. These are some of the "important points. And at the rank meeting we screen our top 60 or so, and I have never heard AOA mentioned in the 4 years that I've been in this program.

Just my 2 cents

I agree with BoneJock. We have had several applicants that had great board scores and were not afraid to let you know (aka arrogant). programs like to have people with adequate scores b/c that does have SOME correlation as to your ability to pass the written ortho boards. However, they also want someone who is eager, humble, hardworking and TEACHABLE. I was not AOA. I had a board score in the mid 230's and I got 16 interviews (most of which Bonejock happened to be at!)
I only had one person ask me about AOA, and it was if my school had announced the "winners" yet (mine had not). In my opinion hands down to best way to improve your standing somewhere is to spend a month there and do well. Plain and simple.