First, analyze why you are looking for the position. If you have participated in the slave exchange errr, I mean match and were unsuccessful, have a candid look at why. Then look at what you need to do to fix this.
Your dean and medical school counsellors can be very helpful. Go talk to them. There are a variety of reasons to do this, not the least of which they can be good sources of insight. They also have their finger on the pulse of medicine and will know about potential openings, or where to look for them.
Once you've identified the problems/weaknesses, develop a plan to explain what you are doing to remedy them. (This assumes you didn't match and were unable to scramble). If you don't do this, you will be less likely to convince someone to give you a go.
Finally, it will be as much of a being in the right place/right time/good luck and network building. This means looking at SDNs open position forum, other program director's association web sites, finding out who the chiefs are in your chosen (or perhaps not so chosen) specialty and getting in touch with them. Everyone in your shoes approaches this slightly differently, but right now, it is all about networking. When I was looking for a position I called a PD, explained my situation and was told, gee, if you had called a day earlier, I had my matched candidate tell me he wasn't coming and someone else called and I gave them the spot. This was a matter of timing and luck.
Persistence, perseverence, networking, developing and maintaining good relationships are all hard work, but absent major show-stoppers, will likely eventually pay off.
