One of my high school physics teachers likened final exams to baseball. Fans don't care what your record was during the season; they only care how well you do during the playoffs.
He told us he didn't care when during the semester we learned the material, only that we had learned the material by the end. Physics is cumulative, so being able to do advanced physics demonstrates that one has mastered the basics. And so, days before our final, he announced his grading policy. If one did better on the final exam than on any earlier exams, then those exam scores would be corrected upwards to one's score on the final. If I scored 90 on the final, any prior exam score below that would become a 90.
In some regards, medical school has a different philosophy. I took anatomy during my first semester of medical school. After taking my final, I will never be tested on the material until I sit for my boards at the end of second year. Similarly, physical exam skills are tested once, early in first year. But they never appear on the boards, so they aren't even tested again.
Perhaps it's because I'm currently in the thick of finals, but it seems like a more cumulative approach would be better. Otherwise medical students segregate knowledge into what is testable and what is OK to forget. The real world and the human body are much more intertwined than that.
