Something that you have to understand is (and this is something you probably wouldn't understand unless you were a med student yourself) is that your SCHOOL's best interests do not always match with your ROTATION's best interests.
Your school's best interests are to get you to graduate and into a residency without too many problems.
Your rotation's best interests are to get you to be there as much as possible, and not blow them off.
In many cases, your rotation takes precedent over your school. Your student dean isn't going to step in and piss off a rotation director, a rotation coordinator, an attending, and a resident, unless it's something MAJOR. Step 2 CS, as weird as this will sound to you, is not considered that major. Your dean will likely tell you that you should've scheduled it for a weekend.
Well, the truth of the matter is:
a) You don't ACTUALLY know how hers works. She hasn't gone all the way through it yet.
b) You don't actually know how hers works because you aren't there all the time.
I mean, you can make the argument that I do know how *mine* worked, seeing as I graduated from it, and I've had numerous friends at different med schools around the country as well.
And I appreciate that your advice is influenced by a "point of common sense." However, since when has medical school/residency EVER been influenced by common sense? It would be "common sense" for interns to get paid for orientation....which we don't. It would be "common sense" for Step 2 CS to be offered in more than 5 locations in the country....which it isn't. Etc.
And God help your wife if both of you think that attendings and senior residents are influenced by common sense....because trust me, a lot of times they aren't.