Contrary to what failedatlife keeps arguing, doing well on classes/Steps and doing well in research are not mutually exclusive. Especially when you are looking at competitive fields like derm, Rad Onc, and surgical subspecialties, almost all applicants have good stats in everything. I was able to excel in all domains - classes, clerkships, Steps, research, and LORs - and applied to a surgical subspecialty. I was able to get interviews at virtually every top academic program in the country, but at all of the interviews I was surrounded by other applicants who had also excelled in everything.
If you want to have a good shot at a competitive specialty and/or program, you have to be great, not merely good, at everything. Don't be someone who is one-dimensional and does a ton of research at the expense of doing poorly on classes/Steps, or vice versa.