Assessment is an integral part of the curriculum. However, the assessment tools, devised more than a century ago, have not kept up with changing scenario of health care and demand of the consumers. In the present scenario, what is tested is a one-time assessment at the exit examination as a surrogate marker for real and observable competence. Most Indian medical schools employ the traditional assessment tools that hardly permit testing of most competencies desirable of a physician; i.e., skills in communication, management, collaboration, professionalism, medical knowledge, health promotion, and counseling. Also, the competencies are not assessed in real time situations. A few medical schools have tried to bridge the gap by introducing the second generation tools, yet the overall approach and methodology is fraught with major drawback of fragmentation and non-contextualization. The physician is supposed to satisfy the patient in a holistic manner or in other words, win the trust. It is this trust primarily what needs to be assessed. The present article stresses on the need of a global assessment conducted on an ongoing/periodic basis, with adequate weightage given to the opinion/assessment of the consumer. Utility of some newer tools including mini clinical evaluation exercise (mini-CEX), direct observation of procedural skills (DOPS), multisource (360º), and portfolio based assessment is discussed. Finally, we introduce the reader to the concept of assessment of entrustable professional activities (EPAs). The concept of EPA helps integrate the theoretical concepts of individual competencies into a measurable parameter of Trust
