I'm not excluding hiring good teachers and TAs from the picture. I'm not excluding paying them a good enough wage to attract talent either. But that's another conversation.

In my university days lectures were paired with seminars. And those had a max size of about 30, and a TA who would explain and help apply the lecture knowledge. The lecturer would visit seminars on rotation and ensure the quality of TAs. And the kicker? The whole gang would be there for the (free form) exam, including the grading.

In short: it can be done because that's where we come from, actually.

And personally I hate multi choice tests, there is no opportunity to see the thought process of the student, or find and be lenient towards those that got the theory, but forgot to carry a 1 somewhere. They simplified the grading, sure, now you can have a machine do it, but thats about it.