I think you can still go into internal med. Just try to get a better score on step 2, and I am sure you can land something good. Dont give up hope. At this point, I would be really happy with a 221. I took the exam already and been having bad feelings since. I can't wait until the score comes out!!
That's a fine score, assuming you are a US student and not a FMG, SDN is just crazy. You will have trouble with some of the highly competitive specialties, and the most competitive programs in the less competitive specialties, but I think you have a lot of options still. What are you interested in?