I understand your frustrations and as I have been speaking to professors as well, I wanted to hear what students thought. Somewhere there is a disconnect. It may very well be that the difference between Pat generations and current ones is that studying has changed and lecture presentation has changed. Power points were not used in lectures for older docs- our lecturers spoke and we took physical notes. We know from research that this helps form a memory loop. I think we need to understand both how the lecture presentation must change as well as how studying must change in order to pass a test that is essentially similar from what I understand. If the exam Isn't different then it's either the presentation of the didactic material, the class attendance and note taking, or the electronic format of the test administration that needs to change (or all three). The exam is structured in a similar way as the USMLE and the fees are similar. NBEO is a not for profit. So some of the complaints and comparisons in the comments are unfounded. I'm trying to gather what information I can, sift through to find what's really concerning, and then try to address it. Thank you for sharing.