There are definitely cutoffs at many programs of whether your app will even get looked over. I think this cutoff lies around 230-235 at most programs. If you are in the 220s or lower, from personal experience, I think your app will get screened out almost immediately at some programs. I think taking Step 2 early with a 240+ on step 1 is a bad idea because there is always the off-chance you will score lower on Step 2. I think there is also an understanding that it is much easier to do well on Step 2 so if you don't destroy Step 2 with a 240+ on Step 1, that could potentially hurt you.
I scored in the mid 220s for Step 1 and took a month off in July to take Step 2, then did ortho sub-is Aug-Nov. I scored 254 on Step 2. It was one of the best decisions I made. I ended up with 15 interview offers mainly from mid to low tier programs and was asked about my Step 1 vs. Step 2 score in half of my interviews. I had some answer about the mistakes I made in approaching Step 1 and how I adapted during MS3 to be ready for Step 2 and I felt this answer was received very positively.
I agree with previous posts that if your Step 1 is below 235, you really need to shine in clinical clerkships or research to get yourself noticed by programs to get interview offers. I attribute my 15 offers to excelling on clinical clerkships.
I know some top tier programs have cutoffs because I was able to get a top-tier interview only through a phone call from an attending. At the interview presentation, the PD made a comment about how they only interview those with 240+ Step 1 scores.
