I'm an img that matched this year, so I can offer you what I learned from the interview trail. I had some time off b/w graduation and my start date (I started during an off cycle start date). I found that almost every director asked what I was doing since I graduated. I had been involved with research and that usually sparked a great conversation with them. I found that most program directors liked the fact that I was involved in research. So, I would try to get involved in some research (PM&R focused).
Secondly, you may want to look into observerships. Montefiore offers one in Bronx. Just take your ERAS list and start emailing residency coordinators regarding yourinterest in doing an observerships. Perhaps you can get a stronger LOR from this experience as well.
I'm sure your persistence and hard work will pay off. Good luck!