We were recently challenged with trying to maintain the integrity and learning experience of our Physiology course, which included the use of long-answer, essay-style test questions, with a class size that increased over 2 yr by approximately 200 students. We reorganized the teaching assistant (TA) support structure in an attempt to keep the testing style and mark (or grade) the exams accurately, in a timely fashion, and provide feedback to the students that want it. Each of four TAs became experts in two sections of the course. To assess our success, TA time allocation for specific duties was recorded. Marking (or grading) accuracy was assessed by recording test data including the number of tests returned for remarking and how much marks changed by when a grade was reassessed. Student feedback was solicited to determine whether this structure provided adequate feedback and support to the students. TAs spent an average of 115 h and 35 min plus or minus 7 h 21 min of a total of 140 h contracted. On average, 13.2 plus or minus 0.5% of the tests were identified as being inaccurately graded by 4.2 plus or minus 0.7%. When asked to score whether the statement of assessment of students was fair, it scored 4.5 out of 5, where 5 equals strongly agree. When asked whether the course provided a worthwhile learning experience, the question scored 4.84 out of 5. Thus, we were successful at marking the exams accurately, in a timely fashion, and providing the necessary feedback, and we were successful at maintaining the objectives of the Physiology course with a class size of 440 students. (Contains 3 tables.)