I don't know what chances i have at good programs let alone top programs. I am depressed knowing that most people who are applying to all these programs have better board scores than i do. My Step 1 was 225-229 and my step 2 just came back and i was down by 4 points but did not release my scores. I passed my IM rotation but did great in my AI with a letter coming out of it. As i read through these threads, i feel i don't have a chance at great programs because everybody is always in the 250's. I go to a mid tier school and that does not help either. I have chosen to apply to approx 30programs. All top tier programs, some great programs and some back-ups but i'm actually thinking about eliminating all the top 12 IM programs since it may be a waste of time and money as i may not eveen get an interview in these places. I have other things in my application that makes it stronger..like research, volunteer experiences, good LOR'S, my background and a good people person and personality(though the later 2 may be in the eyes of the beholder).
What are your thoughts on eliminating these top programs from my application???
Thanks..

I feel like there is no harm in applying to a program, unless you feel like you are gonna be devastated by rejections. At worst, you just get a nice note saying, "Thanks but no thanks." Who cares? At best, you get an interview and potentially match at an oustanding program... but give yourself a chance.

And there's more than 12 programs that would be considered "tops" - there are plenty of programs that I interviewed at that were not top 12 by either US News or NIH rankings that I felt like would set me up to get a fellowship in the specialty of my choice and whatever career I wanted, should I take the opportunities offered. Apply broadly, be prepared for rejection, and enjoy any pleasant surprises that come through.