Don't academics do this multiple times per year, every single year? With similar cohorts coming through each year, don't you think we all have an incredible amount of expertise in setting scaffolded exams, with marks that spread over the entire range and separate out the students?
No doubt. However at some institutions and in some subjects most academics will not have been through the British system before being appointed. For example DS was able to take quite a specialist course taught by quite a big name visiting academic, and another who, though his academic credentials were sound, had spent at least a couple of decades doing rather than teaching. Plus one, again a small course, who was perhaps more focused on research who was known to reuse questions from previous years. (The students were not about to tell!)
University is not school and some of the best academics appear to be, at best, reluctant UG teachers.
The issue for DD is that she is a guinea pig on a new course apparently imposed on the University with both staff and students feeling their way. There are teething problems, but in many ways it is fine. The NHS is unlikely to be any less disorganised. She has decided the best approach is to make sure she is on top of all the academic stuff they have been taught, and indeed plans to spend part of the summer revising. Apparently they will face major exams at the end of their first clinical year, and that the clinical year is pretty hectic. Plus my understanding is that the final exams are national exams which help determine what F1 and F2 placements they get, so as long as she passes the one she just took it does not matter too much.
In short, Universities and courses vary a lot. I agree with a pp. Not all subject experts seem to be skilled at setting tests.
It is weirder in the US where mid terms etc help determine your GPA and grades seem to follow a set distribution, ie depend on class placement. It seems not unusual to get 100% (you are being tested on maths etc that you have just been taught) so 99% could mean that you are in the bottom half of the class, with a grade to match. Obviously with so many tests this evens out, but it is frustrating to miss out because of a single mark. .