I don't think you're hosed but I do think you'll have to apply to a crap-load of programs. I just had an interview during one of my AI's and the program director told me he was much more impressed with excellent clinical grades than a high step 1. So in your situation, I would apply to a lot of programs and then maybe even call the program director and tell 'em about your good step 2 score and excellent 3rd year performance just so you don't get weeded out by your step 1 score. Best of luck...

First off, I wouldn't call any program director (before interviewing). That might be a good way to get yourself cut off a list. Surgeons are busy people and the last thing they need is some med student bugging them about getting an interview.

As for your comment on scoring in the 90th percentile. Keep in mind that that 2-digit score on your score report USMLE report IS NOT a percentile. My 2-digit score was like a 93. My board score was 228, and I'm certain that that's no where near 90th percentile.

Lastly, you're not hosed. you'll just have to use the shot-gun method for applying, kick butt on AI's, and interview well at the interviews that you do have. And good job on taking step two early. it should help you out a lot. hope things go well.