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Brown Medical School embarked on planning a competency-based curriculum in 1989. The curriculum was fully implemented in 1996, effective for the MD class of 2000. To graduate, a student must (1) demonstrate mastery of the medical knowledge base, (2) achieve beginning and intermediate levels of proficiency in nine key abilities, and (3) attain an advanced level in the ability called “problem solving” and three other abilities that the student chooses based on his or her interests.The nine abilities are effective communication; basic clinical skills; using basic science in the practice of medicine; diagnosis, management, and prevention; lifelong learning; self-awareness, self-care, and personal growth; the social and community contexts of health care; moral reasoning and clinical ethics; and problem solving.As a major educational innovation, the new competency-based curriculum has been successfully woven into the fabric of the medical school learning environment. In this article, the authors describe how faculty go about assessing students' performances relative to the nine abilities.