This report discusses a working group convened in Varna, Bulgaria, by the World Health Organization to examine trends, issues, and problems regarding assessment of health professional competence and to prepare guidance to improve existing arrangements. Following a summary of the proceedings, the main portion of the paper reports main findings and recommendations of the group on three topics. First, a set of principles are set forth that were developed to guide the development of assessment systems. Seven principles deal with the function and content of assessment. Eight principles are also presented that should guide educational institutions in the organization, structure, and methods of assessment. Next, four implications are discussed for application of the principles with regard to the use of different assessment methods. Finally, strategies are suggested for implementing those procedures. Some recommendations are then summarized, including reduced emphasis on assessment of factual knowledge, evaluation of performance in real life settings, diagnostic evaluation instead of pass/fail examinations, encouragement of developmental research in assessment of health care professionals by member states, facilitation of implementation of recommendations by member states, and provision of appropriate facilities for the educational development of staff by member states. (YLB)