hey dr. levine, i want to thank you for your informative posts and helpful advice. I got some helpful information from you last time, at this point i am a third year student at a top 25 school on the east coast. i have a 252 step 1, but i am finding the nature of third year grading to be extremely arbitrary such that i cannot gurantee myself all high passes/honors but find myself getting mostly passes. i work extremely hard but the grading system is just so whimsical. i love ortho and cant do anything else. do u suggest i take a year off for research, or international work? all i really have is my step 1 score, my school name, a few decent extracurriculars and not much else. in order to match at a program like columbia, is there anything else i can do- research pubs from a year off, international work for a year, etc that can make me a better applicant? or do u suggest a research elective- and apply. i dont mind where i get in as long as i can do ortho. even community programs are great...but mu goal is a program like columbia.