As medical schools begin to make inroads into delivering an integrated curriculum, success hinges on the ability to evaluate outcomes aligned to this integration. A curriculum can only be as integrated as the last piece of the puzzle -  assessment. As it stands, assessment in majority of medical schools struggle to integrate across systems, disciplines and years. Since assessment drives learning, it is imperative for assessment to reflect integration in order for learning to truly take place in an integrated manner. Hence, this session serves to focus on the challenges and barriers in designing and implementing an integrated assessment as well as the strategies to overcome them.