A core function of some Professional, Statutory and Regulatory Bodies (PSRBs) is setting national examinations which form part of the requirements for practising in a particular profession. In some professions, examinations can form the majority of assessment leading to eligibility to practise but in others are part of a more mixed diet. For some professions, national examinations are well established but for others they are a more recent phenomenon: currently in the UK two major professions – doctors and solicitors – are consulting on the introduction of such examinations. National examinations are changing: rather than relying on more traditional written or multiple-choice styles, examinations are being introduced to assess professionalism, soft skills and practical skills. Designing and running these kinds of examinations on a national scale presents significant logistical problems but this chapter describes several examples of this being achieved successfully across the world. As well as having a gatekeeping function, national examinations can be used for quality improvement purposes and this chapter includes two quite lengthy example of this drawn from the General Pharmaceutical Council’s experience of running its Registration Assessment, a mandatory requirement for registering as a pharmacist, and the impact it has had on education and training providers.