What's up, y'all! Would appreciate any advice on my program list and overall competitiveness, and whether it's too top-heavy.

School: low/mid tier state school in the Midwest

Pre-clerkship: P/F M1 (all pass) H/P/F M2 (4/8 honors, rest pass)

STEP 1: Pass

Clerkship Grades:

Honors: IM, surgery, OB, psych
High pass: Neuro, FM, Peds

STEP 2: 271

AOA: Nominated, decent chance

GHHS: yes

Research: 1 first-author paper in a high-impact journal, 1st-author published abstract, 4th-author conference paper, multiple posters at local and national conferences

Extra: Decent leadership and volunteer experiences

Career goals: Academic, interested in cardiology and pulm/crit
Geographic preferences: East North Central, South Atlantic, TBD on third (debating Pacific vs. Middle Atlantic)

Gold signals: UChicago, Northwestern, Duke/UCLA

Silver: Duke/UCLA, UNC, Emory, Georgetown, WashU, UIC, Case Western, Rush, UCSD, USC, Colorado, Wisconsin
Other programs I am considering: Penn, Pitt, Jefferson, UCSF, UW, Columbia