The transition to virtual learning formats during the COVID-19 pandemic necessitated substantial curricular adjustments to the University of Hawai'i John A. Burns School of Medicine. This study compares student satisfaction and academic performance between the pre-pandemic (up through March 25, 2020) and pandemic (after March 25, 2020) periods. Standard end of course surveys for first year (M1) and second year (M2) courses and exam scores were compared between the pre-pandemic and pandemic groups. The median exam scores for problem-based learning generally increased for M1 and M2 courses during the pandemic, whereas Anatomy scores showed variability with some declining and some remaining stable or inclining. End-course evaluations indicated a significant decrease in student-perceived effectiveness for PBL, Lecture and Anatomy during the initial pandemic period. However, survey ratings for the learning environment improved in later courses, suggesting adaptation over time. Notably, Anatomy exam scores and course ratings improved significantly later in the pandemic which may be attributed to the development of virtual resources and early introduction of in-person sessions. This study provides insight into the dynamic effects of the pandemic on medical education, enhancing understanding of student experiences and academic outcomes during this challenging time. This study underlines adaptations in the curriculum that were effective, highlighting the resilience of the curriculum and students in maintaining quality education during the pandemic.