Definitely not out of the game d/t lack of step 1. You might get a few interviews even if you don't take step 2. But with a good step 2 (above average) you should get some looks. Try to do some aways or make connections to a program. Research is another way to build your cv and/or get a letter. Like wolverines83 said you'll need to apply broadly. I had the same COMLEX score with an average step 1 and 2 and applied to 73 programs. I think that was an appropriate # for me, as I was able to turn down a few interviews and still have a good number to rank. You'll have to decide what feels right to you, but probably between 40 (if regionally restricted or a very focused list) to 75+ if you really want to see who bites. There's a separate thread somewhere (a few actually) that detail which programs are DO-friendly, but as noted above the vast majority are...you'll just be limited somewhat by the lack of a step 1.