The importance of step 1 score varies depending on program (some programs may have cut offs?). Personally, when reviewing applications, I see little difference from a 225 to 235 to 245 to 255. There are many other sections to the application where I place more weight. With that said, if someone scores sub-220, they must have MANY other things on the application to bring them back into the competition for an interview spot.
I feel the quality of the medical school and what you did during medical school are more important than scoring a 265. Personal statements, quality of letters of rec, ophthalmology activities, publications can make a 235 applicant look much better than a 255 applicant.
Once you obtain an interview, the score becomes even less important. The interview itself becomes the most important.
To summarize my opinion - Programs want productive, hard-working, and smart residents that will become outstanding doctors. They do not want unhappy and lazy residents - no matter how well they scored on a test in the second year of medical school. Try to show you are in the former group in the application - prove it to the program during the interview.
