okay so i'll start since i'm currently in third year and just finished my first hospital block. COSMOS is genuinely nice equipment wise, like the mannequins they have are the high fidelity ones that can actually simulate breathing, pulses, pupils reacting and all that. but to answer the actual question, how heavily is it used, i'd say it depends a lot on which professors you get. some of them are really into it and will schedule full simulation labs. others kind of mention it exists and that's about it. it's not consistently integrated the way i expected when i enrolled.