Just curious - How much of a difference is being #1 in your class vs. being in the top 15% or so? Is there any significant difference in how PDs would view your application?
They will notice the most difference if it gives you AOA. As a famous program director once told me "AOA goes a long way".
I do think if someone could say you were #1 that would be pretty incredible, but I'm not sure it makes a huge difference.
Unfortunately I am at a DO school, so we don't have AOA (though there are a couple of similar organizations). The reason I am asking is because my school seems highly ignorant of board relevant material and teaches in a style that can only be described as pure information overload. My rank is high but I am struggling dividing my time between class and Step 1 prep.
Unfortunately your Step 1 score is crucial for an allopathic residency. Most programs use it as a screening tool and use it to rank applicants. If you truly have to pick one or the other, a good Step1 score will do you more good.