um - well the obvious thing is you need to pass step 3! That will obviate the concern about you not being able to pass and get licensed. Your chances will also depend on what you have been doing since you graduated med school. If it's nothing productive, you're hosed. If you have been working on things to the furtherance of your career or getting healthcare related experience then you might be okay. You need to be willing to go for any position, anywhere. Your last chance to apply and have any success is this yr. After that it will have been >5yrs and you will be automatically screened out of most places, if you aren't already.
You need to show a commitment to a career in psychiatry, do some externships, get some recent strong letters of recommendation, hopefully make a positive impression at places where you do externship to get an inside track to a residency spot. You should also get involved with mental health volunteering, see if you get can on the board of some local mental health charities (e.g. NAMI), and look for other opportunities to demonstrate your passion and commitment to a career working with people with mental illness.
If you have decent social/interpersonal skills I would also recommend you attend AADPRT, APA, and the AAP annual meetings (ideally you would be presenting but it is too late for that for this yr) and network. Sometimes showing up, talking to the right people, and making a positive impression may endear someone to mentor you, offer you an observership/externship, project you could get involved in, or even a residency interview. You should also consider getting involved in the local district branch of your APA which will allow you to get involved in advocacy efforts etc, and also to network.
Not sure how much advice you got, but you needed help years ago. Your chances are severely narrowing. In addition, it just gets more competitive each yr while you becomes increasingly uncompetitive.
