I do also think that exams are often a pretty bad way of checking how well a concept is understood and grades often show how well certain things are memorized instead.

I should probably do some more research before I say anything more about this though as that impression is mostly anecdotal.

I guess that's fair, but most of the complaining about this I see online is for stuff like people not writing their own essays. I also think the more pressing issue that's getting people killed in those cases are artificial barriers to access, like if the barriers to practicing medicine were drastically reduced then at least people would be able to get treatment to begin with, and it's not like having gotten good grades by successfully cramming for exams guarantees professional competence.

It's a broader topic, but I disagree, the strategy of outsourcing trust to centralized institutions this way is fundamentally a bad one, and naturally becomes more dysfunctional the more it is used. People need to exercise more of their own judgment, and rely more on the judgment of people they know personally. It's just too much weight for one structure to bear.