Background:Medical education was significantly impacted by the COVID-19 pandemic and the abrupt shift to online education on lockdown. Online education challenged and negatively impacted medical colleges worldwide, especially for medical training and teaching clinical skills that require practice and clinical encounters. The aim of the current study was to evaluate the curriculum delivery and assessment of the internal medicine course during the COVID-19 pandemic lockdown (2019–2020) and compare the assessment results to a control pre-COVID-19 year (2018–2019).Methods:The study design was a retrospective study. All 3rd-year medical students (a total of 882 students) enrolled in the internal medicine course were enrolled in the study: 303 students in 2018–2019, 299 students in 2019–2020, and 280 in 2020–2021. In March 2020, there was a sudden shift to online education due to the COVID-19 pandemic. All lectures were conducted online in the same number and with the same content. Clinical bedside teaching was replaced with selected videos that demonstrated the clinical examination skills planned in the learning objectives.Results:During COVID (62.4%), students performed better than pre-COVID (59.5%) on the medicine midterm multiple-choice questions (MCQs) examination. Similarly, students' marks in the long case during-COVID (84.6%) were improved compared to their marks pre-COVID (82.0%). A very strong correlation was found between midterm MCQs and final MCQs (r= 0.74;P= 0.000), followed by the objective structure clinical examination (OSCE) (r= 0.50;P= 0.000) and long-term MCQs (r= 0.29;P= 0.000). There was only a weak relation between midterm MCQs and DXR (r= 0.02;P= 0.67). Similarly, the final MCQs were strongly correlated with the midterm MCQs (P= 0.000), followed by the OSCE (P= 0.000).Conclusions:The present study demonstrated the success of the introduction of adaptive changes in the internal medicine course to cope with COVID-19 pandemic restrictions. It showed how medical education continued during the COVID-19 pandemic while ensuring student safety. While other medical education methods could be implemented and allow for similar results, innovation in medical education methods should continue to evolve even after the pandemic.