I matched uro with a sub 600 score (new account for anonymity), so it's possible. That being said, it is far from the norm. while I want to give hope, I'd say if you are in this spot, get a backup plan in place. Seeing friends go through the Scramble was painful, avoid at all costs. The success of reapplicants to urology is abysmal. I applied to two other specialties (gen surg and some medicine) which was overkill and made for a crazy interview season but I had a plan.
So my advice to overcome a low step 1/2 score:
1. Everything else has to be pristine. Grades, research, extracurriculars, LOR'S, etc. should be exceptional. Don't give another reason for them to doubt you. Show dedication and desire to be a urologist.
2. Work hard on audition rotations. Being on the other side of things, you can see a difference in students.who are engaged, interested, and want to work. Come in early, stay late, volunteer to help, ask questions. All of these things are well known, but doing it all day everyday for several months is tough. Push yourself to be the best without taking down people around you.
3. Develop relationships. Your application gets you to the door, how you interact and fit in gets you through it. I am by no means an extremely outgoing person or much of a salesman but I tried really hard to get a "feel" for the program and see how I fit in. Making genuine relationships with residents and attendings will help move you up the rank list if people go to bat for you and say, "i really liked being around this person, they would fit in here". I was told that this conversation happened for me on many occasions.
4. Sell yourself. Do.not hide behind your scores. Do some reflection as to why you didn't do as well as you wanted andbe able/willing to discuss this and why you think you aren't a reflection of that number. This was the most uncomfortable part of my interview experience until I embraced it and quit trying toake excuses.
I recognize that I Ann very lucky in getting a spot but I didn't stumble into it. If you have a blemish, be it scores or something else, you have to work harder to overcome it because every year there are 40 people with applications as good or better than yours. Work hard, follow your gut and have a backup plan