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We are a partnership which began in 2002 under the Fund for the Development of Teaching and Learning (FDTL). Our work focuses on creating and sustaining collaborative processes for the generation, and recurrent quality assurance of assessment items and date. Our processes are currently dedicated towards content for the assessment of higher cognitive skills, specifically through scenario based multiple choice, and extended matching items. We have 16 UK medical school partners and we will shortly expand to include all UK medical schools as part of the new Medical Schools Council Assessment Alliance (MSCAA). A new strand of work will in the near future begin as we open up or resources to the Medical Schools Council (MSC). MSC will select a common set of items to be featured in all UK medical school final exams, to enable inter-school comparison.