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Hi! For context, I go to a top MD school in TX. I had trouble adjusting my first semester and failed one of my first few courses (a histology class), which I remediated in the summer. My transcript will say "pass," but my MSPE will include a note about me initially having an incomplete. This eliminates me from the AOA running too (although I am not sure I had much of a chance at AOA in the first place). I am interested in a competitive specialty—ENT. How much does this hurt my chances? I hope to compensate with high STEP/quartile ranking since my school has graded clinicals. Has anyone here (especially from the south) had experience with a similar situation?