It's systems based. You do all the systems twice. First year embryo, physio, anatomy, biochem. Second year all that with a heavy emphasis on pharm and path. From the very first exam you will be tested with board style questions. You are given 90 seconds per question for the first block. By your third block in that will be reduced to 75 seconds per question. The schedule for us has been MCM - Immunology - Musculoskeletal (major anatomy) - Cardiopulm - Renal. Next semester is endocrine, repro, neuro, intro to path (intro = first 6 chapters of Big Robbins), microbiology.
We have additional courses in OMM, PCM (clinical medicine) that align with our blocks (learn how to do a full heart and lung exam during cardio pul, learn how to put a foley in during renal or repro) as well as bioethics and bioinformatics (which includes grand rounds presentation that also align with the blocks).
Test-wise we have exams every week (either in your main block or in PCM, OMM, a few bioethics and bioinformatics in there too). If we don't have actual exams we have competency check offs (learn 15-30 OMM techniques and perform a select few of them randomly in front of a faculty member or fellow, you must say all parts of the technique orally to pass).
This curriculum sounds insane and it is but it's worked in terms of building you up for boards and preparing you well for it (RVU and TCOM were at the top for board scores with this curriculum).
Seriously though, the biggest thing that will get you through won't be yourself, it will be your classmates helping you. You'll come to appreciate them very much so. 🙂
Also, the admin and faculty are there for you, they do have an open door policy. Also the second years are an absolute vital resource for tips for studying and what not so we expect to hear your questions come next fall 😉