There is a girl that used to be on here that matched in plastics somewhere in Chicago. She did F1 I think and a year of research in the US, step 1 and 2 were around 230 she said.
Obtaining an integrated PRS spot (as an IMG) is VERY difficult but not impossible. If you're set on your career choice, you should try. Having USCE, U.S. LORs, research experience/pubs/awards will give you a fair chance to get into General Surgery (more likely a preliminary spot, unless you've worked in a GS research lab for 2-3 years). Although Plastics is ultra-competitive, I know a handful of IMGs (UK, Ireland, Germany, Israel, Canada, Brazil, Colombia, New Zealand) who have matched into integrated programs.
Connections are key to get PRS interviews. Although, my scores weren't insanely high (236/225/passed), I had a competitive application (4 publications including a first authorship in The New England Journal of Medicine, 2 national awards, 1 fellowship/grant for $30,000, 2 book chapters, 6 months of USCE with very strong letters from 2 big names in Plastics, a "Green Card" obtained through my research accomplishments). PDs/Chairmen advised to ask my mentors to contact a few programs to let them know about my application.
I got 9 PRS invitations, 4 were "IMG friendly" (U. Chicago, Yale, U. Mass, Mount Sinai), 2 were small programs (UC-Davis, UVA), the rest were compelled by my story. I did fairly well during the interview trail, programs seemed to like my passion and enthusiasm about the field (I'm madly in love with peds for personal reasons).
Research worked for me, but it won't translate into success for everyone. I'd recommend double applying for obvious reasons (odds increase as more interviews you get). I ranked 16 programs, matched into U. Chicago, one of my top choices.
