Being realistic/chances of matching/advice moving forward

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Looking for some realistic expectations/general advice, thanks for any help! I’m a little over half way through 3rd year, and my school does P/F preclinical and letter grade clinical years. I’ve been a bit disappointed thus far:
OBGYN: B+
Psych: B-
FM: B+
Not 100% but believe this current trend would put me at 3rd-4th quartile class rank, which I’m painfully aware is suboptimal. My evals tend to be excellent (yet the number system my school uses is dreadfully subjective), but I can’t overlook that I have dug my own hole by scoring below average on all 3 shelf exams. I am in IM and really excelling in the hospital, and making good changes to study habits that, barring improvement in the shelf exam, should move the needle into the A range.

I’m not a gifted test taker, but can really perform if I dig my heels in and make necessary changes, so I’m confident in my ability to show significant improvement (and reassurance) via a great Step 2 score.
Research includes 2 pre-med 2nd author pubs, 2 postbac pubs (first author JoVE, 3rd author Nature Comm), upcoming pub as 3rd author in ICU related AI paper, and 3 ongoing Urology projects, one with potentially high impact and the other a 1st author lit review. I also have 1 poster presentation, a school award for MS1 research project semi-finalist, and currently submitting to some AI conferences for the ICU paper. I also know 2 great Urology attendings very well here.
For leadership, I was an officer for an Ophthalmology free clinic for a year, then senior officer, and soon to be director, the highest position in any of our free clinics.

Do I still have a chance? Is it possible but only with very significant improvement/in what areas? I have time, but I want to be realistic. I have loved Urology since my first exposure in 1st year, but I need to keep my future in mind if I need to find another interest. Any advice/insight at all would be greatly appreciated.