Your initial issue will be those bloody filters that PDs use to decrease the # of apps they have to review. Most filters I know of (n=10) have their Step 1 set at 230. I heard a few are higher. My med school even had a honors filter that categorized you in terms of how many 3rd year honors you had...< 2 meant no interview (but that's a rarity).

With all that said your best bet is what your letters say, how you do on your away rotations, what else your app is composed of (meaning that their is always more to an app than a Step 1 score...is their something else about you that would interest them), and the calls your chair/PD make for you.

Also while this may be controversial, I would advise you do an away rotation at a place that guarantees rotators an interview. It would suck to waste 1 month at a place and not get invited back. Its definitely possible, to make it with your Step 1 score but it will be an uphill battle.

If you were planning on your Step 1 to be the only thing that carried your app then thats a problem, but if your app is well rounded and you are strong in person it should help you.

Thanks for the helpful reply. I spoke with a Ortho Doc at my school and some other people and they echoed what you said. I appreciate your advice greatly, thank you.

doctajay answered well and I'll also point out that you can get past "cutoffs" by rotating at a program and doing well. The step 1 cutoffs are definitely used to narrow down the number of applications that they have to review, but they will review your whole application if you rotate somewhere. This doesn't necessarily mean you have a great shot but may give you additional opportunity if you really want to end up somewhere. It was a while back but I know I got one interview where I was below the program's cutoff by rotating there.

All in all, step 1 is just part of your application...doing well definitely opens doors and you may have more of an uphill battle, but you can definitely match still if the rest of your application is good and you choose your rotations wisely.

Thank you for your reply BoneDawg I appreciate your help.