The perception of some students that physiology is a “hard” subject to learn has been well documented1. As such, numerous strategies have been employed by educators to assist students with their understanding and acquisition of physiological concepts. One such strategy is to provide students with regular evaluations to allow both student and educator to gauge the level of understanding of particular topics. However, it remains unclear what form of evaluation students prefer and, empirically, which best facilitates student learning and understanding. In this particular study we sought to determine whether students in the first year graduate entry to medicine (GEM) programme at University College Cork preferred to sit either summative individual evaluations in physiology for a certain percentage of marks, or formative, no stakes assessments, individually or in a group, with immediate feedback from the questioner. The study was conducted over the first two semesters of the GEM programme. In semester 1 students each sat 5 separate summative 20 question evaluations on computers, with each test worth 0.2% of their final end of semester physiology mark (i.e. 1% in total), and feedback on the questions provided at a later date. In semester 2, students sat 4 entirely formative evaluations, with each conducted using the cloud-based student response system, Socrative. For these tests, students could participate either individually or in collaborative groups (to facilitate peer instruction). At the end of the study period, 54 students (66.7% of class; 27 male, 27 female) completed, or partially completed, an anonymised survey, collecting information on both student demographics and their views on the summative and formative evaluations performed in semesters 1 and 2. Survey responses revealed that students found both forms of evaluation almost equally useful both for providing feedback about their understanding of physiology material (86.5% strongly agreed (SA) or agreed (A) for summative vs 88.5% SA or A for formative) and for identifying deficits in their physiology knowledge (75% SA or A summative vs 78.8% SA or A, formative). However, a significantly larger number of students indicated that they felt that the summative evaluations provided a greater motivation to study and keep up with taught material than the formative style of evaluations (82.7% SA or A, summative vs 63.5% SA or A, formative; p=0.015, unpaired t-test, n=51). In spite of this finding however, slightly more students indicated that they would favour the formative (31.4%) to the summative (29.4%) evaluations if they were given a choice, although this difference was not significant. Our findings indicate that pre-clinical medical GEM students value both summative and formative evaluation roughly equally to facilitate their learning and understanding of physiology, although for slightly differing reasons. Slominski T. et al. (2019) Physiology is hard: a replication study of students’ perceived learning difficulties. Advances in Physiology Education, 43, 121-127.