Going to piggy back here.
Also finishing 3rd year, my step 1 was in the low 240s, I have no research, school is not known well outside the region.
The biggest issue is I had a lot of family issues my first two years, didn't handle them well, and failed second year. I repeated and had no trouble.
3rd year grades have been all passes, with "excellent" grades in professionalism and interpersonal skills and clerkship comments to that effect, but no honors.
My dean seems to think that my step score negates the concern PDs will have for the early academic issues, but I'd like to get anonymous second opinions from people who have no vested interest in alleviating my concern.
I don't think anyone cares about years 1 and 2, especially if you redeem yourself with a high step 1.
You should be able to get interviews to at about half the places you apply to.
I think you'd be fine with applying to 25-30 programs.
That would give you at least 12 places to rank, which is more than you need and leaves you plenty of wiggle room.
All the programs are accredited and I don't think the difference in the quality of education is as great as people make it out to be.
By all means, if you have a specific area of interest, pursue it.
I don't think there's a better place than Mayo for ultrasound, for instance.
But does anyone really believe that you'll be a better physiatrist for having gone to UW or RIC than you will be if you train at Case Western or UVA?
Apply to a few prestigious places.
Apply to plenty of solid, middle-of-the-road places.
Then apply to a few places that you'd like to save for back-up.
If you don't have a specific focus (research, MSK, Sports, etc) at this stage, I'd advise you to find a place where:
- you'd like to live
- you get along with the residents
- you get free, convenient parking
- you like the facilities
Work hard, study your ****, and you'll do well.