Also, the very exam could be the same (unlikely), but the grading standards could be much higher at one school compared to another. The class discussions could also be very different, even if they're on the same material technically. The nature of the interactions in student study groups could be completely different. At one school, the student sitting next to you just got named a Putnam Fellow for the second time. At another school, no student has ever, in all history, been named a Putnam Fellow.

It's quite hard to get a sense for what a course is truly like just from glancing at the syllabus.