I think that depends a bit on where in the world you are. I don't know much about university in USA but I know a fair bit about high school and college. While here, in HS, no one can get all A's. Maybe one in 1000. To get the best grade you have to be pretty much flawless, and no one is that good in all subjects. American kids seem to be able to do all A's, which tells me that grading is different. Also, what they take on college level, we take in grade 10 through 12.

If university is as harsh there as it is here, it would be a huge jump from what they were used to prior.

But something I don't get if the OP is faking, why would they here? We don't exactly prescribe meds.