A lot depends on whether your a US or foreign student obviously. My thoughts:
1) Step 1 is huge, but maybe not quite as huge as people make it out to be. So many other things matter and now you obviously need to focus on those.
2) Step 2: When you're a little more emotionally removed, reflect on what went wrong on Step 1 and don't repeat it. Plan your step 2 prep for the year and make sure you have some idea how you can be prepared to crush it. Questions throughout the year? Firecracker? Review course? Extra time off btw 3 and 4 to study?
3) Networking: your letters and phone calls are going to be huge. If you suck at networking, start not sucking at it asap. Once you know what you want to do, start getting to know all the people in that department and figure out who the power players are. Get involved. Be a good team player. Be kind to EVERYONE. Be the absolute best clinician you can possibly be. Ask people lots of questions about themselves and then shutup and listen - this is really the essence of networking. Be interested, and be interesting, but do it in that order. In the end, you definitely need stellar letters and maybe even a phone call or two from well known people to programs you're really interested in. I've seen some really low scores match some very competitive specialties, and this is often a deciding factor.
(on that note, there was a study in some journal [academic medicine maybe?] comparing the responses of PDs and applicants about what's most important in ranking applicants. The one thing that PDs mentioned as one of their top things was "personal knowledge of the applicant.")
4) Research. Get thy arse involved in some asap. Some good pubs can help.
5) Honor as many rotations as possible. Everyone knows that Step 1 tests a lot of crap that doesn't matter, so if you say an applicant with across the board honors, decent Step 2, good research, stellar letters about how they are the finest student in years, etc., it makes the low Step 1 score look like an outlier. If you show up to interview and are the most charming, interesting, and enjoyable person I've met and someone I wouldn't mind hanging out with during in-house call, then I don't really care that 2 years ago you didn't know how many ATP you get out of the Krebs cycle.
6) Accept reality. Standardized test scores are not how you're going to get where you want to be. I know that sucks, but it's probably true. The best case scenario is that test scores won't screw you too badly. Take this opportunity to focus on what you CAN do well and play to your strengths. Be careful not to spend so much time on a weakness that you don't fully develop your strengths. Find your strong area(s) and perfect them.