Thanks for A2A
I think there is nothing wrong in setting small term goals like getting gold medal for university. Of course your main focus should be on clearing concepts and learning clinical skills.
It depends on how well you have presented the answers. Make use of flowcharts, write in points.
As 75% of the paper usually comes from the important topics known by many. So the difference basically lies in presentation of your answers.
Also if you get mcqs in your university exams, you need to have a good knowledge of the subject.
Try to write while revising a topic and review which points you left out.
All the best :-)
Shubhi Agrawal, MBBS from MGM Medical College, Indore (2020)
Source: Quora Digest