To all current 3rd years out there:
Take a deep breath and RELAX!!! You all have plenty of time; just enjoy things right now!
As far as you go, you can pretty much write your own ticket. Step I- 260s, Honors, research or not will get you more interviews than you know what to do with. Don't take Step II until after you interview. No one asked about mine, and I took it in July.
Regarding Away rotations: Do as many as you can!!! This one thing alone will set you apart from every other applicant who didn't rotate there and you get a chance to see if you'd really be happy there. Most places will automatically give you an interview if you rotate there and don't screw up. I recommend doing aways in Sept, Oct, Nov and especially Dec. In July and August the programs are dealing with the new interns and won't have much time for you. Plus, just think how many students will come after you if you do one early. The only exception is if you need LORs, then do one early. I did an away in Dec and it was great b/c I was the only student and the last guy to rotate so they easily remembered me for better or for worse when I interviewed.
Advice (Finished interviewing): High-tier programs are great if you want to be a big time academic person. The saying is that you start with a five foot retractor and they take a foot off each year!!! Be sure you know what you want out of a program and in your education: size, # of residents, location, stability, staff, OR and clinic time, fellows, and RESIDENT COMRADERIE. I would say 95% of programs are great and 5% questionable. No matter where you go, you still come out being board eligible. Fellowships are out there to be had and really isn't too much of an issue b/c someone on staff knows someone else and so on. It's a small world. Each program is unique and it really boils down to where you'll fit in the most and what you want out of a program!