Medical education, the art and science behind medical learning and teaching, has progressed remarkably. Assessment is entering every phase of professional development. A wide range of assessment methods currently available include essay questions, patient management problems, modified essay questions (MEQs) checklists, OSCE, student projects, Constructed Response Questions (CRQs), MCQs, Critical reading papers, rating scales, extended matching items, tutor reports, portfolios, short case assessment and long case assessment, log book, trainer's report, audit, simulated patient surgeries, video assessment, simulators, self assessment, peer assessment and standardized patients. Assessment has a powerful positive steering effect on learning and the curriculum. Assessment is purpose driven. Mastery testing (criterion-reflected tests) requires that 100% of the items are measured correctly to determine whether students have attained a mastery level of achievements. Self assessment (self regulation) is a vital aspect of the lifelong performance of physicians. Self assessment approaches include: written exams (MCQs, True/False, Essay, MEQs, modified CRQs), performance exams (checklists, global rating, student logbook, portfolio, video, etc). Long Essay Questions can be used for assessment of complex learning situations that can not be assessed by other means (writing skills, ability to present arguments succinctly). The questions can incorporate clinical scenarios.