You should check out the medical student forum on auntminnie.com and read some of the messages. I thought I read that a few people got a spot this year with Step I below 215, but I don't remember the rest of their application.
Here's my info, although I'm considered to be in the top 13% of my class via the Dean's letter, I'm at a primary care school rather than a big research school (Michigan State). Step I 230, Step II 259. Honored nearly every clinical rotation during my 3rd year. Honored a couple classes (very few though) in my preclinical years, but I don't think it matters at all if you were #1 or last in your preclinical years as long as you did well on Step I. I have research, but none in radiology. Had great letters, spent a lot of time on my personal statement. Moderate amount of extracurriculars, nothing special though. Did NOT get AOA though. Three part criteria at my school: grades, extracurricular, research. Really only had the grades.
Got about a 65% hit rate on the interviews and I only applied in the Midwest (and only to 5 states). Got denied interviews at a few places I would have gotten (spoke to secretary at the program) but I didn't apply until October 23. Don't do this, please apply early, very early it does help.
Ranked 13 programs, didn't rank a couple and matched at my #3 place. I did an away rotation at my #1 choice, was told by the residents, PD that they would love to have me there, did call with the residents, saw my evaluation and all 5's (out of 5) and great comments. Still didn't match, maybe I turned someone off but I would have been very happy with any of my top 7 and satisfied with any of the programs that I matched into. Still hurts a little not getting your #1 though, but expect this, the field is competitive and PD do talk to each other about the applicants so never bad mouth any program while on the interview trail.
Good luck.
