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I am a US MD senior applying Internal medicine this cycle. I go to a Florida MD school. I am 3rd quartile (my school weighs pre-clerkship more than clerkship). I have Honors in IM, Neuro, and Psych, with Passes in Surgery, Pediatrics, OB. OB and Peds were my first 2 rotations. My school grades clerkships on H/P/F. I also have GHHS. I have 12+ posters/publications, with 6 first author along with start up company involvement, national advocacy with patient advocacy groups, volunteering, and free clinics. I have a 255 Step 2 score, and passed Step 1 on First Attempt. How reach do you think are programs like Baylor COM, Mt Sinai, UF, UMiami, Tulane, Wake Forest with signals, or is that too competitive? Like how realistic are my chances of going to a top 50 IM program, or do you guys think I can do better or worse. My school said that I schools like Baylor or Mt Sinai I shouldn't bother applying to because of my class rank, and that the class rank will screen me out at many programs despite my Step 2 score being within 25th to 75th range for most of these schools.