UAB and Wake are both good middle ground programs. Like a previous poster said, Duke/UNC may be out of reach, though submitting an application can't hurt. It's been about 5 years since I was in your shoes, so things may well have changed, but I remember Vandy didn't have any DO's (which upset me as a DO who wanted to live near family in Nashville) and I didn't even get a response to my application (not even an end of the season rejection). Some programs have automatic cut off points for Step 1 scores which could be anywhere between 215 (unlikely) to 230+, but 227 will hopefully get you past most first round rejections.
As for audition rotations, I've never found them to be very important in anesthesia. Knowing for certain that you want to do anesthesia tends to be more important than a program seeing how you are in the OR. Unlike disciplines like surgery where they may want to see some skill, in anesthesia everyone expects you to completely forget all your anesthesia knowledge and lose any skills you may have had by the time you finish intern year. I didn't intubate a single person during the first 11 months of intern year (my program had an anesthesia boot camp for interns the last block of the year). I placed very few lines and hadn't adjusted a ventilator during that time either. It didn't matter because all those skills are learned by repeating them hundreds of times during residency. The program wants to know that you can become a board certified anesthesiologist (IE jump through the hoops the ABA puts in front of you), and they've decided that correlates most directly with Step scores. Anesthesia is one of the most difficult disciplines to pass the board exams (or so the ABA says).
Do audition rotations at UAB and Wake if YOU need to know if they are right for you, or if you feel like maybe you can't land an interview otherwise. If you know that you want to do anesthesia and you've got appropriate references, then you may accomplish just as much doing an elective washing dishes in the cafeteria at UAB/Wake, so long as they give you time for a coffee break to allow you to say hello to a few residents and smile/small talk the office staff some. Pick what you feel you need, but don't expect audition rotations to make an application. You can, however, completely eliminate your chances by doing poorly on a rotation or causing some problem that gets you remembered. For example, I had a helpful medical student attempt to wheel the bed from the room with the pts IV fluids caught on a railing. It was an honest and simple mistake. It resulted in an IV pole and pump crashing onto the very much awake pt. She didn't appreciate the pump landing on her arm. I didn't appreciate that problem being my responsibility. I can't remember anything else he did that block, good or bad, but he didn't get into the program. My recommendation would be to cherry pick rotations where you can ensure the results are in your favor, then pick the easiest (least real) rotations to fill out your year and enjoy the last vestiges of freedom before you are swallowed completely by the soul sucking machine that is residency. If by the time you've submitted your rank list you are still going in to a rotation more than once a week you've picked the wrong rotations. Good luck.
