Looking for advice on IM signal list. Coming from mid to low tier USMD NY med school. Looking to go to program that will give me an opportunity to pursue any fellowship. I worked at Cornell for two years and have strong ties to department hence the gold.

Step: P/256

Clerkships: First quartile, 6 honors (med and surg) 1 high pass. Honored sub-I. Letters from sub-I attending and medicine attendings.

Research: Four abstracts with posters at conferences, one oral presentation, one publication. No first author work

Extracurriculars: Moderate amount of volunteering, nothing outstanding.

Honors: Not selected for AOA/GHSS

Geo Prefs: New England, Mid Atlantic, South Atlantic (have family in all regions)

Too aggressive? Any other programs I should consider or should I shuffle my gold signals around?