Prior to Fall 2023, the two medical campuses of the University of Minnesota, have hadtwo different curricula. Though the Duluth campus has delivered an integrative, systems-based curriculum, the Twin Cities campus has delivered a discipline-basedcurriculum. Outcome measures (1) pass rate and scores on Step 1 board exams, 2)graduation data and 3) match success) demonstrate strong comparability betweenthe two curricula. Starting in September 2020, another opportunity for comparisonoccurred; a single instructor taught pulmonary content to both the Duluth (Fall 2020)and Twin Cities (Spring 2020) cohorts and another single instructor taughtcardiovascular content to both the Duluth (Fall 2020) and Twin Cities (Spring 2021)cohorts. Both cohorts were given and assessed on the same set of learning objectives;leading us to ask the following question: Does the structure of the preclinical curriculum(systems vs discipline-based) impact the learning outcomes of physiology, particularlythe ability to integrate material? We compared the two cohorts by comparing acommon set of exam questions assessing cardiovascular and pulmonary physiology. Wemeasured question performance by question diffculty index (expressed as a percent)and question cognitive level by determining the Bloom’s Taxonomy Cognitive level(knowledge, comprehension, application, analysis, synthesis and evaluation). We foundno differences between the cohorts in question diffculty as a function of content typeor levels of Bloom’s taxonomy. We conclude that there was no difference in overallperformance of the Duluth and Twin Cities cohorts despite receiving different curricularapproaches. However, we had an unexpected finding from the analytics; thecardiovascular items were significantly more diffcult than the pulmonary items. Thisresult has implications for a team-taught medical school curriculum given the source ofthe difference could be the difference in teaching style, the difference in content or thedifference in item writing. We therefore are beginning an exploration of the differencein item analysis and possible impacts on student evaluations. The important of this lineof inquiry is that first, consistency in item diffculty potentially impacts a competencybased medical curriculum and second, how students perceive differences in itemdiffculty has the potential to affects instructor evaluations and therefore promotionand tenure. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.