It is not possible to just add something in the middle of a curriculim and fix it. Especially if it involves more and increasingly difficult exams.

You should not increase the difficulty of the exams until you have increased the efficacy of the instruction and materials. If you assign a new and improved text yet text the old lectures there is a disjoint. If you make daily quizes like the USMLE you will just breed discontent. You don't take the USMLE until you have been prepared. We are not short on USMLEs we are short on preparedness.

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