Medical education, particularly clinical education, has moved primarily to a competency-based medical education (CBME) model whereby the focus is on the outcomes demonstrated by the learner. These can be seen in the focus on individual competencies (such as the Physician Competency Reference Set and the ACGME Core Competencies) and on job skills competencies (such as Entrustable Professional Activities). However, adoption of a competency-based model for preclerkship education, especially in the foundational sciences, is rare. Characteristics of CBME – focus on outcomes, emphasis on abilities, de-emphasis of time-based training, promotion of learner-centeredness – appear challenging to accomplish, particularly in knowledge-focused courses. Moreover, the concept that assessment of competency is an assessment of the learner’s knowledge, skills, and abilities irrespective of the source of those competencies are counterintuitive to the concept that the learner gained their competency due to the educational intervention by the faculty. At the same time, there appears to be a contradiction between typical assessment of learning in most preclerkship courses through summative examinations and the assessment for learning through multiple formative assessments which provide information on the progress of the learner. The purpose of this focus session is to address the foundational concepts of CBME and investigate how this educational approach could be applied to preclerkship education.