Evolution of student assessment in McMaster University's MD programme

In response to the competitive examination culture that pervaded medical education in the 1940s and 1950s the founders of McMaster University's new MD Programme created an assessment system based on group functioning within the tutorial. While the tutorial has served the educational process well, 30 years of experience has highlighted its deficiencies as an assessment tool. This paper describes the accumulation of evidence that led to the awareness of the weakness of tutorial assessment and the attempts to provide reliable assessment by the reintroduction of examinations, but in novel formats which would not alter the goals of the curriculum.