Its hard to guage difficulty. Only 11-12 people out of about 115 GMS students in medical physio got an A. Conversely, 25-30 got an A in Endo, and probably that many also got an A in Immuno. So you would think Endo and Immuno would be far easier. I did well in all three, but found Physio easier because it was more conceptual, while Endo and Immuno were straight memorization, which is harder for me. So it really depends. Along those lines, Biochem, Endo, Immuno, Pharm and Path (especially) are memorization classes, while Physio is more conceptual. Histo is evil because it has a mixture of both--a ton of memorization, with a large conceptual portion. I have not taken other classes offered by BUMC, but from my undergrad classes I would say Genetics is conceptual while any Neuro class is memorization.
You can push research back as far as you want, but you have to be enrolled at BUMC even if you are not taking classes. For example, if you take Fall and Spring classes and then decide to take the summer off before beginning research in the Fall, you have to fill out a form describing how you intend to spend your summer, and possibly have it approved by your advisor (only if you plan on taking two semesters off or something), and pay the continuing education fee. If you decide to take Fall off, you would do the same thing.
Some people pm'ed me about classes. As a general guide: Everyone has to take Biochem and Physio. I recommend one semester med Physio because I took it and liked it, its fast-paced, you can get it over with over 12 weeks and not have to worry about it all year since its a major requirement. Most everyone also takes Histo. Everyone registers for at least 3 (usually 6-8) research credits. And a lot of people place out of Biostats. Given these presumptions, you would likely take Biochem, Histo and 3 research credits in Fall and Physio and 3 research credits in Spring. Thats 15 credits in Fall and 9 in Spring. To fill the other 8, I would not recommend another course in Fall since Biochem and Histo are a lot of work and you want to do well in those two particularly. Instead, you may want to add an additional 3 credit research class to use later. That would bring you to 18 credits for Fall. In spring, everyone should take Endo and Immuno since they are med classes, in a separate block, and did I mention they are med classes and thats the point of this program? So if you substitute one research class to Fall and take Endo, Immuno and Physio that would leave you with 12 credits in Spring. You need to add one more class and 2 credit hours to meet their 8 class, 32 credit hour graduation requirement. There are a number of classes you can add in Spring for 2-3 credits. If you really want to, you can add Biostats, which is 2 credits and an easy A, or opt for something more challenging with the 4 credit Path class. Its really up to you. Since you dont have to decide for a while and and will have a better idea about BUMC and which subject areas you're interested in after Fall, I wouldnt worry about it yet.