After talking to a good number of program directors, it seems that they pay a lot of attention to Dean's letters, comments/evaluations during 3rd and 4th year rotations, and letters of recommendations. Obviously, good board scores and grades can only help but most PDs want people who are going to get along with others. If it's a choice between someone who didn't do too well on the boards and someone who got negative evaluations during their rotations, I think most would choose the lower board score. A lot of my interview questions centered around my character, how I handle difficult situations and patients, and how I would work with a team.
I don't really care to repeat the discussions we have had in the past about board scores and "competitiveness" of the field. I think the general consensus is simple: the top tier programs are more competitive, board scores and grades matter but not as much as evaluations and letters of recommendations, and program directors look for fit as much as anything else. My PD likes to talk about "competency" a lot. Competency is very difficult to measure. Just because someone does well on the boards does not mean they are a good clinician. If you ask most patients, they will remember the bedside manner and personality of their physicians.