I got a 271 on Step 1. I didn't tell anyone except a few family members. On residency/fellowship interviews, on occasion people would comment on it but overall it was never a big thing, because it is only one part of the picture for your application. As far as competitiveness for residency, as much as I would like it to have, I highly doubt it added ANYthing more to my application than a 261 would have. I think it's reasonable to shoot for 250+ but please do not waste emotion and energy trying to get anything higher.
Stay humble