Your cake is not even half baked. You still have:
-Clerkship grades
-SubI
-Step 2CK (more important)
-AOA potential
It's not a great score but all your goals for a top school are still in play as I highly doubt even MGH is screening out Step 1 <240. Also, midtier MD school in the NE... Are we talking BU/Rochester or Rutgers/NYMC? There's a difference.
Regardless, 250+ on Step 2 + Honors in Medicine will get you interviews at top places and probably a match at a mid/upper tier place ultimately.
AOA will catapolt you into the elite tier level. It's not an exact science, but being part of an exclusive high performing group PDs can filter out on ERAS is a big plus.