So what do you mean by a good step I score? Don't have to answer. Where are you at school?
The most important factor, I have gathered, to gaining a top residency spot is experience or even a strong interest in the field. The program directors I have met speak very highly of candidates who come on interviews and are able to state why they like pathology and what they hope to get out of residency. You don't have to have a specific career in mind, mind you. Believe it or not, the personal statement is often important (although some interviewers don't read it).
Many successful matchers have done a post sophomore fellowship, but that is certainly not universal. The advantage of a post sophomore fellowship is that programs know that you have spent a year experiencing pathology and know what it is about and what makes a good resident. You also are likely to have great LORs, and have an understanding of the field that helps you a lot on interviews and residency searches. Research experience often has a similar effect on your chances, as it may indicate the type of mind you have and what your interests are. Pathology is, without a doubt, an intellectual specialty, and anything that demonstrates this will help.
Board scores are important, I will not lie. Step I score can help you land interviews at top places, and a very high step one score can make you very competitive. Grades kind of fall in a similar path, although generally people with good grades also have equivalent step scores. Step II can help also if you do it before the match, as one PD I interviewed with told me the step II score is a better predictor of who will do well in residency. I started getting interviews quickly after submission of my application, and all the programs had at that point were my step I score and my CV, which included a PSF, one submitted publication, and a few extracurriculars. I have not done heavy research (yet). I got interviews at every place I applied and this included the so-called best programs in the country, some of which told me I after the interview I would match there if I wanted. I have heard rumors of some programs having Step I score cutoffs for interviews but don't know how true this is.
My clinical grades were actually also so-so. Did not make AOA here at UMass although AOA at UMass factors in volunteer work a lot.
I encourage you, as I always do, to look through the archives of this forum and see what else other folks have said. And I of course encourage others to respond to this thread with their thoughts.
