Advice/Reality Check

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First of all, there's no guarantees even if you were AOA and had a few publications. I know several such people who didn't match. So there's always going to be anxiety no matter what. Furthermore, you have an excellent step 1 and good grades. I would go ahead and apply. Do an away rotation if you can and try to write a case report while on it. Plenty of people match with the same or worse credentials on paper. If you don't match, do the intern year and apply for a research fellowship. People seem to be pretty successful with this route. You just have to have the attitude that you are willing to do whatever it takes to match no matter how long it takes. You'll eventually get there.
 
Why take a year off before applying?
If you're willing to lose a year, wait to see if you don't match and then do a research year if you don't.

I thought about taking time off for research because I wasn't super confident in my application. I was hoping for 3-5 interviews, but got more than a dozen and matched at top choice.

I've also heard of people postponing graduation after the match, doing a research year, and re-applying as a senior medical student and matching. In my opinion, I don't think that makes a huge difference.
 
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