Are my dreams of EM over?

Background - US MD student at Mid-Lower Tier US School - No issues throughout academic history prior to Step1 - I have no idea what happened, I was projecting 230+ on all my practice tests and just found out that I scored a 193 (failed by one lousy point). All I ever wanted to do was EM at a trauma center and according to what I've read so far it seems like that's over with regardless of how well I do on a retake. My campus dean told me that if I do well on my retake and Step2 that I could... Are my dreams of EM over?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums