Similar, except the fact that the NBME uses an extremely small resolution for their test. If you read my post on the big thread, I mentioned that there are subtle differences between the FredV2 and Uworld, although Uworld emulates it almost perfectly. With the real Fred V2, everything is scrunched together, you have to scroll more often and stuff. As a result, questions SEEM to be longer than what you are used to. On my exam, most of the questions I encountered are similar in length to what I experienced in UWorld and the free NBME questions. Additionally, most people who use UWorld at home have a widescreen LCD screen with a nice big resolution such as 1600 x 900 or 1920 x 1080. The real exam is like 800x600 resolution, square screen, you have to scroll down often. You even have to scroll down to click on the last couple of questions (on the left side that lists all of the question numbers).
In addition, the sequential questions are presented differently. After you finish the first question, the 2nd question is shown underneath the first, instead of a separate question. Also, the sound questions are different because they provide the different auscultation points you need to listen to, unlike USMLE world.
So there are definitely differences between the Fred V2 interface and Uworld, enough to make you consider trying it out, especially when the NBME provides it for FREE! When you do the Fred V2 free questions, the screen appears like a square in the middle of the screen with a similar resolution to what you will encounter in the real thing. I have zero regrets doing these questions 3 days before the test.
As I mentioned before, I strongly recommend doing the Free NBME questions to get to know the REAL interface and the differences from UWorld.