Long-term planning for residency

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HorseObsessed

Cornell CVM Class of 2030!
2+ Year Member
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Hi, if you've seen me on here, you know that I'm always worrying about something, so here goes:

Broadly, what to do to prepare for residency applications? Specifically large animal surgery. I'm honestly not sure I even want to specialize but I want to keep it on the table.
What matters?
Grades/ Class rank?
Publications?
Externships?
Letters?
Clubs?

I'd love to chill out a little bit about always getting an A (academic advisors said 3-4 people a year get an A in our anatomy class). I'm currently on track for an A-, but I know harder classes will come. I could stand to focus less on grades if it doesn't matter as much as other things. Do I need to super focus on grades? Is it better to start doing some research? (I will have one publication from undergrad, third author in a pretty big journal hopefully, but my advisor mentioned this as a key point for residency).

As a perpetual worrier, can you tell me what's worth worrying about and what I could stand to chill about?