All 19 medical schools in Australia examine and assess the performance of their students, but do so largely in isolation from each other. That is, most schools design, develop and deliver their own exams, against their own curriculum and standards, and students pass, fail and are graded with little external moderation or comparison. Accreditation of schools by the Australian Medical Council (AMC) provides some reassurance that assessment practices are appropriate in medical schools. However, very limited data are available for benchmarking performance against any national standard, or between medical schools in Australia. The Australian Medical Assessment Collaboration has been designed to meet this need. The AMAC will allow nationwide comparisons between medical schools. The AMAC was initially conceived as a joint project between the University of Queensland, Monash University and the Australian Council of Educational Research (ACER), and was funded as a strategic project by the Australian Learning and Teaching Council over an 18- month period to mid 2012. The project included scoping, engagement, development of an assessment framework, compilation and validation of sample test items, and pilot exams.