sucky step 1 scores

You have a shot at any of those fields if you are an american graduate. All of those fields currently accept a large percentage (internal is almost 40%) of foreign medical graduates, and most programs with foreign medical graduates would prefer american graduates (they get more in medicare money to train american grads and it makes them look more prestigious). So you might not get internal at Harvard, but the community programs and a lot of the university programs will still be open to you. Also remember that programs tend to rank third yr grades higher then your board scores, and if you do an audition rotation that might help too. Keep your chin up!