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Ok for one, there is no such thing as “an Ivy League residency.” And two you clearly don’t know the power of a connection if you don’t think a connection alone wouldn’t be able to cut it. Who you know is far more important what what you know.
The guys was probably a great applicant, I’m still doubtful he had some mythical step score as I have yet to find a stellar DO match that had one. Usually these applicants look like an MD on paper and have made some sort of connection.
What’s your definition of mythical? The average for MD students for ENT is very high already. And Penn is a top 10 hospital in the nation.