i'm a final year medical student in pakistan, and i'm quite certain i'm going to get low step scores. this is not about self-pity; it's an objective assessment based on how my study habits compare to those students who have done well on their steps.

what are the chances i will get a residency in the US? i realize that as an img with low step scores, psychiatry, family practice, and peds will pretty much be my only options. do i have a realistic chance of getting one of those in a big city e.g. nyc, houston, la?
approximately how many residencies will i need to apply to, to get a match?
since i'm not aiming particularly high, are clinical electives really necessary?

obviously, it's hard to quantify this stuff, so what i'm mainly looking for is advice from people who've gone through something similar i.e. gotten low step scores and still managed to avoid having to live on welfare. advice from other, smarter people is also welcome. what i'm not looking for are "encouraging" responses telling me to "dream big" or "reach for the stars". thank you