Everything and nothing is true. There are absolutely NO RULES on this, period. DO NOT LISTEN TO THOSE WHO TELL YOU OTHERWISE. It may not be as easy for you as someone who scored over 220, but don't let that stop you. If you believe you don't deserve to get the residency you want it will show in your application and interviews. But you need to be HONESTLY passionate about the field you apply to, and be willing to honestly prove this in person. Some places use cutoffs as a general rule. That doesn't mean a phone call from a doctor you know who would recommend you highly and is in the same field you wish to be in wouldn't get you an interview at a program who sent you a rejection letter. It's up to you and your personality, drive, creativity, and desire. I scored way below what everyone said was "ABSOLUTELY NECESSARY" on step 1 to get into Emergency Medicine. But I did 20 points better on step 2, wrote a heartfelt personal statement, and had outstanding reference letters. I also got an interview after being rejected by writing a letter, not an email, to the program director of a program saying how disappointed I was not have recieved an interview. I wished him luck on getting the high quality candidates he'd had success in getting in the past and said I thought he was passing up an excellent cadidate in me despite my less than stellar step 1 score. His secretary called me the following week to invite me for an interview. I matched elsewhere, but you get the point.