Hey! Totally understand your concerns—this is something a lot of us have asked, especially early on.
At the beginning of the school year, most of our exams were in-house, meaning the professors wrote their own questions based on lectures and course material (and the questions were easier with more 1st and 2nd order questions aiming to build students up to the harder 3rd order questions. But after the board scores came out, the school realized there was room to improve how we’re prepped for Step 1. So starting in Trimester 2, especially with the MSK module, they began building final exams using NBME question banks ( I believe the professors are still free to write questions on mid-term exams). These questions are more 2nd and 3rd order and are more aligned with what we’ll see on boards, so it's definitely a step in the right direction in terms of board prep.
That said, it’s still a balance. The professors that are not phDs, meaning MDs or DOs, are practicing clinicians, so they focus a lot on teaching medicine as it’s actually practiced today—which is great for clinical reasoning and long-term learning, but sometimes board exams love to ask more obscure or outdated stuff. The good news is, the curriculum is evolving, and they’re trying to integrate more board-style content without losing that real-world focus.
And honestly, that kind of clinically focused teaching helps you build the skills that will really matter on rotations—like how to think critically, communicate effectively, and make evidence-based decisions. Those are the same skills that will impress your attendings and can earn you strong letters of recommendation for residency.
As for the comment about questions not being relevant or covered—there were times early on when it felt like questions came out of left field. But in many cases, that was due to the growing pains of a new curriculum and transitioning to a more standardized testing style. Since then, they’ve worked on improving question quality and alignment with the taught material. It’s still not perfect, and we’ve had to adapt along the way, but things are getting better each trimester.
It’s true that being part of a new school means we’ve had to be flexible and give feedback as the program develops, but the upside is that the school is responsive and genuinely trying to improve. Hope that helps clarify things a bit!