To be quite frank, you need to re-evaluate you readiness for med school. You know you are in the Caribbean as a 2nd chance, thus "being occupied by a lot of issues" is not a good excuse, except for maybe an unexpected family emergency. Everybody is also "occupied by a lot of issues". You don't have to answer this on the forum, but you need to have a plan moving forward, and find out what you did wrong and correct it ASAP. I would also not go into the 2nd exam with a high probability of failing the course, as I believe it might be SGU's policy for automatic dismissal after one class fail. I would talk to SGU and see what your options are, but do not chance it and take the final and only to have you fail the course.