Oh, how I wish this were true.
I'm married to an MD. Went through the med school/residency journey with her. Soooooooooo much waste and BS in the process.
In direct response to your question, 4th year of med school is essentially a joke. During the first half of the year, everyone is distracted by residency interviews and applications. During the second half of the year, no one really cares because they're ready to peace out. My wife's entire 4th year could have been dropped and she would have lost absolutely nothing.
The reality is medical schools primary metric is percentage of students placed into residency. More prestigious schools care about more prestigious placements, but placement is a must. The primary, almost exclusive, means of ranking resident candidates is test scores.
For most med schools, that means they don't actually care about providing their students with any practical skills. They only care about succeeding on a handful of standardized exams.
In fact, I've seen schools kick students out with exams failures so they can artificially keep residency match rates high.