Chances?

I got a 232 on Step 1 (not much different than you). And went to a state school out east that isn't top-tier by any means. Got satisfactory/high satisfactory on most of my pre-clinical courses (with a couple honors here and there). I got all honors on all of my required clinical coursework and a couple electives that were "high-sat." A couple non-published abstracts that I had submitted for publication and were rejected. I ended up getting elected to senior AOA since 3rd year grades are the most heavily weighted at my school it seems. Also, I got a 274 on Step 2. The Step 2 score was brought up at every single interview and that is really the only significantly different factor on my application than you have at this point. I applied to around 70 programs and was offered 21 interviews (couldn't attend 2 due to scheduling and cancelled 1 that I was not interested in). Ended up matching at a place that I'm really enjoying right now. Just apply to a lot of programs, in all different "tiers." I say this last thing because I interviewed at a handful of top tier places like Brown and Mayo, etc as well as a handful of community programs as well as everything in between. Just interview with confidence and don't pretend like your application isn't good enough.

Sims -

Thanks for the very helpful reply. I'll get my Step 2 score back in the next week or two. I'm hoping it went well but you just never really know.

Yesterday I had a school surgery official tell me that I need a backup plan. He thought I should rank a local general surgery spot as a plan B. Any thoughts?

Could you tell me how much you thought your letters of rec helped you? I'm working on those right now. I'll have two or three ortho letters and one or two non specialty letters.

Thanks again.

USMLE I - 256
USMLE II - Won't take until later
More or less decent State Medical School
Research - Some, but no pubs
Grades - Pass/Fail first 2 years, 3 H in required clerkships, the rest are HP, Ortho Grades - So far 2/3 H's.
2 aways at strong, but not very fancy/famous programs
LOR - No one really famous

What do you folks think?

I guess if you're okay with doing surgery also, then maybe you could interview at some surgery programs as backup and rank them at the bottom of your list... but if you want to do ortho then I would apply for ortho for sure, don't let some surgery department big-wig scare you into thinking you have no chance (maybe they have other motives). I'm not sure how much my LORs helped to be honest. I just had letters from not-famous academic attendings and even a general surgery letter, so although I dont know what they said I don't think their names carried any weight.

Just got my Step 2 score back yesterday. Went up from Step 1 by almost 30 points! What a big relief. I feel much better about my prospects and am glad I took Step 2 early.

I think I'll have similar letters to what you described.

Thanks for your thoughts.

Congrats, and good luck with the application!