Uro 2 here at a DO Program.
OP--I don't want to say it is "impossible", but I would say you need to have a VERY REALISTIC back-up plan. Your level 1 score is going to be extremely difficult to overcome. I know at my program you would have little to no chance. Our top 5 ranked applicants this year had COMLEX scores in the mid 600's to 700's. I know it's not the news you wanted to hear, but I think it is important to be realistic going into this process. There is nothing wrong with applying, but having realistic expectations will help you have a better match experience.
That being said, you will always here of that one person that "wowed" a program, etc. Things are changing a lot in the DO world though. Our program (as well as most or all of the other DO uro programs) will be soon ACGME accredited. Our program is ready to submit things on June 1st this year. This means the field will open to ALL qualified DO/MD applicants. I don't know we'll have every competitive MD applicant applying to a "new" DO-MD program, but with ACGME match rates in the 60-70%, I'm sure there will be tons of applicants. Audition rotations are important...but it is more important in trying to differentiate between the kid with a 590 COMLEX and a 620. Again, this is from my program experience of N=1.
What are we looking for? Good boards are a must for us--we take the in-service AUA exam every November and there is a big emphasis by our PD to perform well on it. We are expected (as a program) to be above the national average...so this is why being able to "score well" on a test is emphasized (to a certain degree). The COMLEX is a joke though...it's a random test and anyone can have a bad day. Scoring in the 600- 700's on level 2 can help your cause, but you'll still have to convince people that you are the "600" guy and not the "400" guy.
Every single person we ranked had good research experience. It's not required to have a novel prospective study, but at the minimum, having a uro case report or being involved in SOME sort of research shows you know what an IRB is, how to submit abstracts, presenting posters, etc. Nobody will say it is required, but these are the fine toothed things that help differentiate candidates that are ranked closely.
Anyway, it is a tough road...each year, very competitive applicants don't match. It sucks, but it is just the way it is with limited spots.
In the end, go for your dream...but have another plan. Also, remember if you plan on re-applying to uro, you have to ask yourself..."What about my application is really going to change from this year to next?" The answer is, not much. The applicants continue to get more competitive each year...so go chips all in this year!
Feel free to ask me any questions. I'm only on here rarely, but will try to check back in. Best of luck to everyone this upcoming year!