Health professionals require skills and attitudes beyond medical knowledge and pre-clerkship faculty play an early role in developing these attitudes in students. However, because of the heavy focus on medical knowledge during pre-clerkship training, programs often struggle to incorporate experiences and assessments that prepare students for all aspects of clinical work. One approach to addressing this issue is to incorporate competency-based assessment schemes into the pre-clerkship curriculum that are compatible with existing learning experiences. While maintaining the importance of medical knowledge, competency-based assessment strategies allow a more holistic view of student development and can be used to provide coaching for learners in a variety of domains such as practice-based learning and improvement, systems-based practice, interpersonal skills and communication, and professionalism. They also provide students with rich feedback across all aspects of their performance and establish a roadmap that encourages learner development and sustainability.