Current student here - first 1.5 years (preclinical) is in house exams. Clinicals use NBME shelf exams for all the core year subjects like surgery, obgyn, IM, peds etc. Sub specialties in rotations use in house. Most courses are pass, near honors, honors except for MAS and CAPS which is clinical skills and ethics stuff. Typical week preclinicals you have lectures in the morning which are optional attendance, afternoons you sometimes have required things like anatomy labs or some small group meetings where you might work through cases or other activities. Exams are always on Friday and for the science stuff it’s every other week exams. MAS and CAPS exams twice a semester. Clinicals are usually 6 weeks long. It varies a lot based on what rotation you’re on. Things like surgery are going to have longer hours, peds might be shorter. Study for stuff using step 2 resources while at work and when you get home. Exams are NBME exams at the end of the rotation.