Depends on what you're applying for or want to do.
If you have a very solid work ethic and a good personality try to do some audition rotations at places that match people they like. You probably will be able to land yourself a solid match that way if you can impress people and make them see beyond your level scores.
The truth is you're going to be stuck at a lower tier program unless you go to some audition and impress someone. The majority of times that won't happen and they'll still rank you toward the bottom. I would definitely focus on applying primary care: FM, IM, Peds