Purpose. Early underperformance in medical school can heighten anxiety and signal a need to adjust study strategies. We implemented a Safety Net Exam Review Program (SNP) in the first foundational science course at the Univ. Cincinnati College of Medicine. The SNP convenes learners, near-peer tutors, learning specialists, and faculty to address content misunderstandings, examine error patterns, reflect on study behaviors, and identify changes before the next assessment. Methods Students scoring ≤73% on an assessment were invited to an optional SNP review. Participants corrected missed questions, categorized reasons for errors, reviewed performance by content area and Bloom’s level, completed a study-behavior inventory, and set goals with a learning specialist. If a student’s final course grade was below 70% (passing benchmark), they were eligible for a grade adjustment to passing if they fully participated in invited SNP sessions and if they achieved ≥70% on the final exam. The initial program (2025) was built from learner feedback after a 2024 pilot; we analyzed 29 encounters involving 20 students. [A complete second cohort will be analyzed before the forum.] Results Of the four possible SNP sessions, 57.1% of participants were eligible for one, 28.6% attended twice, and only two learners participated three times. No students required all four safety net reviews. Learners attributed 42.1% of missed questions to insufficient content detail and 17.4% to second-guessing. Self-reflections on study behavior demonstrated that practice exams (86.2%) and active recall (79.3%) were commonly utilized practices, while 41.4% identified the lack of a consistent study schedule as a problem. Conclusion A structured second-chance pathway can preserve rigor while normalizing support and promoting learner agency. The SNP generates actionable data on knowledge gaps and cognitive demands, and enables real-time adjustments in study behaviors to guide individualized support.