ABSTRACT It is well accepted in medical education that assessment drives learning. Authentic assessment involves examining the knowledge, skills or competencies that students are expected to exhibit in their future professional practice. In recent times, transparency and public demand for accountability have gained momentum in the context of undergraduate and postgraduate medical education. By adopting authentic assessment tools, medical institutes are better prepared to justify the grades awarded to students and the outside world. The paper discusses the preference of criterion-referenced tests (CRT) over norm-referenced test (NRT) in medical education to support the development and implementation of authentic assessment activities. The value of laying down clear, standardized criteria for assessment has been emphasized to improve student learning and engagement with the curriculum. The paper has attempted to summarize barriers in implementing competencybased assessment, including educators, students, and institutional factors. It also suggests pragmatic measures to overcome these difficulties and the need to adopt a critical view of existing assessment modes.