Well the only way it gets harder is with the practical aspect. In the UK, in my final year of medical school, I have to do an exam (which is just pass or fail btw) to graduate which is split into the theory, called the akt, and the practical test, called OSCEs. For the theory part, everyone just spams question banks and flashcards to pass that easily. the practical half is where most people stumble because you get tested on interacting with patients who are either acting or have real medical conditions so you need to do everything right to get good marks on that. It's quite stressful, from what I've heard. I'm only on my second year out of five but all my exams, including my final theory exam, are all multiple choice. However, the theory section on the ukmla is way way way easier than any of the steps for the usmle, to make a comparison. Step 2 of the usmle is a much harder version of the applied knowledge test in the ukmla. As far as coursework and stuff goes, I will have some stuff next term and in later years where I have to do projects involving clinical research or quality improvement but apart from that, it's not very challenging. Overall, right now, things are very easy. The hardest parts right now are getting sign offs done on clinical placements and doing daily reflection/engagement logs. But it will get harder once more is expected from us, either in our practical skills (being given more responsibilities or roles on placements) or with how much we need to know.