cutoffs are listed for some programs on freida. many great programs either don't have one or have a low one.. i think jhu is listed as 210s or something. i got step1 of 222 and received invites to all mentioned but b&w and jhu, so i guess they don't automatically screen for that score
yeah I think medicine really tries to make a holistic approach.
but still. you must have a lot more to your app with a sub-avg step 1 score for IM. name brand, PhD, lotsa pubs, astronomical step 2, etc.