1) What kinds of programs are you applying to? Are you really an MD/PhD? I'm thinking that clinical- and community-oriented programs that would ordinarily be very happy to see someone with your board scores are thinking "Oh, that person really wants something more academic", and university programs might be less than ecstatic about your IMG status.
2) I don't think that that attempt on step 1 is a big deal with the decent step 2s. Good step 3 will help quite a bit, I'd think.
3) What do your letters look like? Are they research oriented? Are they bland and non-specific? Are they a couple of years stale? You need a couple of letters that say "Dr. dph is going to be a wonderful
psychiatrist." What experiences will get you that? Usually something with hands-on clinical experience is best. Observerships are next to worthless--you can't really be directly involved in patient care.
4) I think you need a
connection. Someone who really sees you as eager to be a psychiatrist and can advocate for you, maybe influence a couple of programs to look at your application. I can't reiterate enough how very many applications just like yours I am seeing: decent, not spectacular boards, "standard" clinical experience, unremarkable personal statement and life/work experience...what is going to elevate you above the other 400 apps just like yours and make me want to interview you? Here, it's usually some regional or personal connection, or maybe the person who tailors their personal statement to our program's actual distinctives and can convince me that they really want us: that out of all the psych joints, in all the towns, in all the world--that you are going to walk into mine.
Oh and one more plug for proofreading your danged emails before you send: got one the other day where the name of our program was combined with part of the name of another program, in another region of the country. It would be like getting a letter from a high school football player asking for a tryout with the New England Giants or the Green Bay Bears. If you're cutting and pasting, for goodness sakes, TAKE YOUR TIME AND GET IT RIGHT. (And no, the fonts didn't match, either...)