I am a M1. I was raped and stalked by a professor in my last semester of college. I then went straight into medical school after a short summer where I went through a miserable judicial process. I was diagnosed with depression and PTSD shortly after arriving at school. I am/was functional enough to attend class regularly and sit for some exams, but recently failed my last exam by less than 1% and thus have to remediate the class. It will show on my transcript, assuming I pass remediation, as "pass with remediation." In addition, I have very poor faculty evaluations because I am not fully "engaged" with my peers in class.
I get that people have a hard time adjusting to medical school, and I am guessing that the combination of being far from home, not having found a support network yet, adjusting to a very different kind of coursework, and the more recent trauma resulted in my bad exam.
Your story is very sad and unfortunate. All of the issues listed above might impact your performance in medical school. Another possibility, and I raise this simply to be complete, is that you simply are having trouble mastering the material. But that's the key -- programs might be OK with taking you if this is all driven by your social situation which you put behind you. But if this is just having difficulty with the quantity of material to learn in medical school (which is often much more intense than the material in college) then that's a real problem.
So, the MOST important thing you can do is improve your performance in medical school, immediately. The rest of my answer tries to focus on that one goal.
There are a few administrators at my school who know about the traumatic events, although my professors don't know. Is this something that would go in my deans letter? (Do deans letters always have to explain passes with remediations? I was under the impression that this was the case) Would I have a choice about it, and if I did, would you advise me to let residency programs know about the reasons for my bad first semester? If I had, say, a family member in the hospital or if I got mono during the entire block I would have no problem sharing that with residency programs. In some sense, what I experienced was no different from any other unsettling life event. But I understand that there is a stigma / victim-blaming associated with mental health issues as well as sexual assault.
There is absolutely NO requirement that this be in your Dean's letter, and in fact I think it has no role there at all. Usually the MSPE will simply state that you had some academic difficulty and remediated it. Sometimes there will be a vague reference to a stressor, or "medical problems", etc. You will absolutely have some control over what is said in your MSPE in this regard. They must talk about the fact that you needed remediation, but they do not need to go into details.
Finally, would the failed class close doors for any medical specialties or for landing a top-notch residency program?
Yes and no. Failing a class is certainly not going to help. Some tip-top programs will review applications and look for a reason not to invite, and a single failure might just do that. But it's unlikely you'd be locked out of a specialty, and there are plenty of really good programs that consider someone with a single failure, or even a bad semester or year.
The key is turning this around. Multiple failures in multiple semesters will definitely hurt your chances. And if you're not absorbing the material well (for whatever reason) and then you don't do well on the USMLE, that will also limit your choices.
I'm currently too depressed to actually care about this, but I also know that eventually I would want to know the answer to this. I am having a hard time in medical school overall but I am pretty sure that by the time I apply to residency my depression and post-traumatic stress will be dealt with; it's just that right now things are still a bit acute. The admin will probably advise me to take a leave of absence, but I am afraid that it would look worse to do that than to just suck it up and get through the rest of (at least) M1 and M2-- let me know if that is the case. In all likelihood I won't fail any other classes because the class I failed was notoriously difficult and apparently it gets easier after this block. If it makes a difference, am interested in path, rads, neuro, and medical genetics in the northeast.
I want you to read that paragraph you wrote slowly and carefully, because you are headed down a bad path. You absolutely do NOT want to just suck it up. If you continue doing badly, that will seriously affect your chances in the future -- and your school may have rules about the number of courses you can remediate before you need to repeat a year, or even fail out. You don't want this "dealt with" by the time you apply for residency, you need it dealt with long before that (understanding that you'll probably be "dealing" with it for an extended amount of time, but you know what I mean). if you're having problems relating to other people, you're going to run into really big problems in your clinical years. And whomever told you that 2nd year of medical school is easier than 1st is kinda crazy -- I thought the 2nd year was more fun than the 1st because you start to learn things that seem more useful, but it builds upon 1st year material -- and if you haven't learned that well it's going to be a problem.
So, IMHO you absolutely should take a break if you can't perform to the best of your abilities. You will have a much better story if you take a break, address your problems, and return to the curriculum and do well. If you continue, struggle, and then try to make excuses afterwards, that won't go well.
You will have a chance to tell this story in your application -- in your personal statement. This will be completely your choice, and will depend on whether you want to talk about it. If it's in your PS, it's fair game in your interviews. Only you will know if you're ready for that.
One question to ask is, if you do take an LOA, what will you do with it? You need to find a way to address these issues, so you can return with your full focus.
