I wouldn't exclude your chances from any residency based on your board scores. Even California programs. While the geography tends to generate more competition, my experience has been that people with all board scores have been able to match in California. I used to sit in these meetings and I have seen people alive in the application process with scores >200. Obviously your stock rises with a higher score, but just keep in mind that there is 9 neurology residencies in California. Things that programs will also focus on in addition to board scores are research, dean's letters, strength of medical school, and personality/likability at interviews. I think it's easy in medical school to focus excessively on your Step1 score (I know I did). We on the interview committee know that there are great applicants who would fit well into the program with low board scores. And vice versa there are applicants with high board scores from top-tier institutions who set off red flags during the interview process and get no-ranked. This is true for all of the residency programs here, including UCSF. I wouldn't apply solely to IM just because of your board score. If you really love Neurology enough don't eliminate your chances.