ACOM lets you do your fourth year outside their clerkship system. If you’re able to find preceptors not attached to a residency program and get approved or apply through VSAS/VSLO, then you’re free to do your electives/audition rotations broadly.
I think it’s very student dependent for boards. However, I did feel that ACOM prepared us well for COMLEX, but not USMLE because USMLE has more biochem and stats on it and ACOM’s molecular medicine class didn’t hit enough board detailed material. The rest of the systems were fine, but reproductive system was overkill. That class prepped you really well for OBGYN rotation, COMLEX 2/Step 2, and the OBGYN shelf, but it was information overload for COMLEX 1/Step 1.
The mandatory Wolfpacc program board prep class didn’t help me at all, but it helped some students. I wish it was optional for students who scored above a 500 or 600 on their practice exam. I preferred to do practice questions and tests on my own rather than having someone lecture at me for 7ish hours a day for 3-4 weeks.