Professional education in the medical sciences promotes mastery for eventual career success. Assessments of student progress should align with mastery matched to the level of the learner. An educational institution strives to develop and deploy assessments with outcomes that are achievable and consistent with student effort in the curriculum provided. This session addresses a fundamental issue: who moves on and who does not? Getting it right is a contractual obligation of the educational institution. Setting a passing standard is challenging and potentially affects who enters the health care workforce. Potential adverse outcomes include failing students who are qualified to advance in their training, or passing students who have not achieved sufficient mastery to move on. This session provides an overview of standard setting issues and will benefit faculty members who administer assessments, assign grades, and/or who are involved in course/curriculum oversight.