Aim for at least 90 on the 2-digit, i think that's a 221? 222?
However, step 1 isn't the only or most important determinant. I failed step 1 the first time, but I destroyed step 2, and I had some research and some good letters from my chairman and from chairmen at places where I rotated. I applied to almost every program (there are 96), and I got 40 invites. And on the trail, very few people have asked about my step 1.
My logic for applying everywhere is that about 1/3 of the places weren't even going to consider me because of my step 1 (places like the Barrow, Harvard, Columbia, etc). If you're heart is set on these schools, you definitely need 95 (230+) or better
1/3 of the schools probably average step 1 and step 2 and take anything around a 90
and the last 1/3 will accept either a good step 1 or step 2, again shoot for the 90.
So if you don't do very well on step 1, take step 2 early (I took it in July, a month after my 3rd year ended), and make sure you do well on your clerkships and get on some research projects. You dont need to publish 5 papers or anything crazy, but have something that you have worked on that you can talk about that shows your interest in neurosurgery. Programs aren't looking for lots of pubs necessarily, but they want to know that you've actually put some thought and effort into your decision to go into neurosurgery
Finally, the average matching scores have ranged from 234-236 the past few years. The average isn't 250, so for every person with a 250-260 who matches, someone with a 200-210 is matching as well. Of course, there aren't that many people getting 250+, and Im sure the curve is very narrow with >75% of people in the 225-245 range, but it's still possible
