| Summary: | In the context of where the nature of the learning environment allows only minimum feedback, and less participation in learning, a uniform national examination seems to be a feasible way to standardize quality in health professions education. However, this kind of high-stakes national examination may represent the social hierarchy indicated in this edited volume. Despite many external benefits, a high-stakes national exam, such as computer-based tests and objective-clinical-skills-examination/OSCE, will drive a society further away from the more dialogical observation-based assessment to approach the individual learning progress. This chapter will discuss the dilemma between the ‘assessment of learning’ and ‘assessment for learning’ in the context of hierarchical and collectivistic culture towards student-centered learning
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