Medical malpractice is very rarely due to gaps in knowledge and is much more likely due to accidents, miscommunication, or negligence. The board exams are not taken at the school and have very stringent anti-cheating measures. The exams are done at testing centers where they have the palm vein scanners, identity verification, and constant video surveillance throughout the test. If there is any irregularity during your exam, it will get flagged and if you are found to have cheated, you are banned from ever taking the exam again. (which also prevents you from becoming a physician)