A very close friend of mine is a radiology resident at Mass Gen Hosp (very competitive of course). He told me that the initial screening process at most programs is based on your Step 1 and 2 scores (if available), medical school name and sometimes the first paragraph of your personal statement. After that initial screening, then they will go deeper and start looking at the LOR's, complete PS, research and those details that make you unique. IOW, if you are from a top 10 school (not me) and have boards of >250 (not me) you are very likely to pass that initial screening process. For the rest of us (humans), it's all about luck and impressing the right person with the right quality. Apparently, my stats are not impressive for most programs so far. Actually, only one was impressed…