I think ITE scores definitely play a big role. I had elite Step scores vs pretty much exactly average ITE scores (everything else on my application was at least above average, including letters), and my interview/match process overall was more reflective of an average applicant as opposed to an elite one. Granted, this is in an even more competitive than usual pain cycle, but I had a ton of residency interviews at “big name” institutions, and definitely not the same situation for fellowship. Still quite happy with my match, but it was very different.