Any chance for a USIMG matching in neurosurgery with a fail on step 1 ?  I pretty much already know the answer but thought I’d ask anyways—maybe someone has advice , e.g., excellent scores second time, and on step 2 and 3, then preliminary surgery, pre-residency fellowship , reasearch etc.

that’s a huge red flag and with all the US seniors applying, you might say you’re done for, at least via traditional means.  you could try to secure a pre-residency fellowship somewhere, but it’s going to be a long and tough road.  best of luck.