How big of a red flag is consistently High Passing but not Honoring M3?

So I am about halfway through my third year, and it's not been going as well as I planned. I did well M1-M2 year (top 15% of class), and very well on Step 1 (260). I have decent research, will probably have 7-8 full publications (5-6 in derm) by ERAS time next year if I dont take year off for research. For whatever reason, I just can't seem to honor my rotations. I do relatively well, and have been High Passing everything with the exception of a pass in OBGYN, but just can't seem to get it... How big of a red flag is consistently High Passing but not Honoring M3?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Source Type: forums