Advancing assessment in general practice: the case for programmatic assessment in UK GP training

Assessment in UK General Practice (GP) training has traditionally relied on high-stakes evaluations that may fail to capture the complexity of clinical competence or support equitable learner development. Programmatic assessment, based on the systematic collection of diverse, low-stakes data points over time, offers a more valid, reliable and learner-centred alternative. This article examines the limitations of the current system, outlines the principles and benefits of programmatic assessment, and explores challenges and implementation strategies. Drawing on international models and educational theory, we propose a shift towards an integrated portfolio-based approach that prioritises meaningful feedback, supports competency-based progression and has the potential to reduce reliance on high stakes examinations.