Super embarassing. Haven't taken it again yet but I expect to pass the second time around. I suppose I just need to explain it if it comes up. Sucks though quite a blemish on my app which before was reasonable, though I'm on the low end for step 1 score- 236. I have good research though and good extracirriculars (lots of service, president of a service club, leadership). Good LOR's and I think I'm a normal person who would interview well. Not incredibly selective on region either I just want to be able to hack bone it could be in Alaska....

Btw there are rumors about Philly and CS...I cant definitely say one way or the other but I personally took it in Philly. Take one anecdotal experience for what you will.