Programmatic assessment is both a philosophy and a method for assessment. It has been developed in medical education as a response to the limitation of the dominant testing or measurement approaches and to better align with changes in how medical competence was conceptualised. It is based on continual collection of assessment and feedback information which is collected in a portfolio and periodically discussed with a mentor or coach. Students produce reflections in which they analyse the assessment information triangulated across methods to meaningfully--rather than purely numerically-analyse their strengths and weakness in the different competency domains. Decisions about students' progress are made proportionally, in that low-stakes decisions are made when only limited assessment information is available but high-stakes decisions will and can be made on rich information. Quality of the process and credibility of the outcomes is determined by a combination of psychometric methods, qualitative rigour, and through organisational due processes. The method is still young, preliminary results are promising but more empirical justification research is needed.