Step 1: 230
Step 2 CK/ CS: Taking soon
School: US Allopathic, not top 40
Class Rank: Lower half
Grades in Clerkships: All pass including psychiatry (Our school is top 15% H, next 25% HP, next 60% P)
AOA: Nope
Research/ Publications/ Extracurriculars: 1 psychiatric publication (first author) which was just submitted but not accepted yet, student governing board, lots of volunteering, started a music therapy/volunteer group
Red Flags: I was on a 5 year program due to serious illness during first year of med school. First 2 pre-clinical years were split into 3. It is no longer an issue. No time off was taken. No course failures.
Overview of where you want to end up: I'm wondering if I am still competitive for the mid to mid/upper tier programs. MUSC, Emory, UNC, Vanderbilt, Harvard Cambridge, U of Colorado, U of Washington, OHSU. I am not stuck on one geographic area.
You are competitive enough for most of the programs on your list, but some places like Colorado and similar state supported institutions like the home team folks - people with geog ties - a lot.
My stats were in line with yours, and I applied to several of those on this list, and I interviewed at MUSC, UNC, Vanderbilt. I turned down the invite to Emory. I did not apply to OHSU, UW, or CU. I did not receive an invite from Cambridge.
My suggestion is to apply to many more than just these. With your profile, try to apply to 15, minimum. IIRC I applied to around 25, got around 19 invites, and attended I think a dozen - in hindsight, I could have done just as well applying to only 15 or so programs, and done fine without 3 or 4 of those interviews (after about the 8th interview, especially if it involves plane travel, the wear and tear on you and your wallet takes its toll). It is helpful to get those extra invites, though, because sometimes it boils down to a calendar / logistics conflict and there will be a few you just can't make it to (cancel well ahead of time, at least 2 weeks).
Get all your stuff in on Day 1. No excuses.
Finally, it is sometimes hard to figure out the ones you get interviews at vs the ones you don't. I did not get interviews at 2 of the 3 programs in South Carolina, for instance - yes on MUSC, no on the other 2. Real head scratchers, but again, some of these progs won't waste invites on applicants they figure they won't get anyway...hence why it is useful to apply to a few more programs than you might otherwise think necessary.
The list of programs I applied to and did not receive invites from is a very strange mix - no from Cambridge - sure, no problem - and then no from USC-Greenville. Umm, OK...what?
Good luck.