In my opinion, you're thinking about this the wrong way. If truly set on PCCM/CMM (also include pulm only as they are generally less competitive and can tack on single critical care year after), then you should be focusing only on the things you can control from this point out. Let everything else go.
Your step scores are what they are, can't do anything about that. Are there programs that will filter you out because of them? Most definitely. There are also programs that will filter you out because of DO, because of community residency program, etc. You will not be able to know which programs are which.
But, looking at the most recent charting outcomes document from NRMP, you can see ~50% of IMGs matched with your step scores, so it's certainly possible (step scores for DOs not available).
https://www.nrmp.org/wp-content/uploads/2021/08/2018-Charting-Outcomes-SMS.pdf
The things you can control going forward are,
1. Be a great resident. People underestimate the value of a phone call from PD/PCCM faculty stating this person is their best resident, hardest worker, etc.
2. Posters at national conferences (ATS, chest, SCCM).
3. Publish case reports. You don't need high level bench research. Publish an interesting case with a subject review. There are journals out there that will always publish these types of things.
4. Research which PCCM, CCM, and pulm programs are your targets. Most programs have websites these days. Look for places that have fellows like you (DO or IMG, community residencies, etc). Be creative and open to living somewhere for a few years that you might not want to permanently settle in.
apps.acgme.org
