<p>1.) While medical school is reputed to get harder and harder as time goes on, it also gets more and more fun. Generally the students I talked to say that the second year of medical school is the one that they mind the most, while third year is brutal but much more interesting. Some schools have quite relaxed fourth years.</p>
<p>Residency, of course, is another animal.</p>
<p>2.) You do receive grades during your third and fourth years and your third year grades are by far the most important ones for residency matching purposes.</p>
<p>These grades are based partly on subjective factors -- how well you take orders, get along with nurses, interact with patients. They're based partly on attendings asking you questions as you go along. They're based partly on "shelf" exams that you take at the end of each rotation.</p>
<p>3.) You read up on patients as you go, learning about their diseases and such. But when people tell you they "study" during their third year, they usually mean that they are studying for shelf exams.</p>
<p>I'm about to say something and want to clarify that I'm not very sure it's true. It's based on what I've heard in my anecdotal interactions with third-year medical students at a variety of schools. From what I've seen, it tends to be the case that medical students at highly selective medical schools tend not to study during their third year, while students at less-selective medical schools tend to do so a great deal.</p>
<p>This does actually make sense: shelf exams are largely based on old board exams, and selective medical schools tend to have students who scored very well on those already. So to them, this is all stuff they've already learned.</p>
<p>4.) While I'm pretty sure residencies do not give grades, there is certainly an evaluation mechanism in place. This is probably reflected in letters of recommendation.</p>
<p>5.) Steps II and III include, I believe, book learning as well as clinical skills. For reasons other than this, however, they are much easier. For one thing, Steps II and III are basically pass/fail. As long as you pass them (a ridiculously low score for US Allopathic schools), nobody cares*, since you've already matched into a residency for Step II. Step I, however, is the equivalent of your SAT score: the higher the better, and this is a very important way by which residencies evaluate you.</p>
<p>*There are exceptions. Some students can opt to take Step II early in an effort to let residencies see their scores.</p>
<p>6.) I'd say 99% is still a significant exaggeration. Knowing what to do and knowing why you do it are very different things, and it's unlikely that anybody really retains all the whys for everything they've learned. I hesitate to give you a percentage, but it's certainly lower than 99%. I suppose, though, this depends on how well you learn/are taught during your first two years.</p>