The assessment of medical competence has a rich history of research and development. This paper provides a short overview of acquired insights and their practical implications. Attention is being paid to competency-based education and its consequences for assessment. The coupling of competencies to more easily understandable clinical tasks, the Entrustable Professional Activities (EPA’s), is included in this discussion. Finally, an explanation is given of a more systematic approach to assessment with more attention on feedback for learning and using this rich aggregated information for robust high-stake decision-making. Provided a proper implementation and with an appropriate buy-in from clinical professionals, assessment may contribute to training better doctors.