In this article, the assessment design of the College of Optometrists’ Scheme for Registration is discussed in relation to underpinning educational theory and research. Features of each stage of the Scheme are presented, together with analysis of the purpose of specific elements of the assessment programme. The Scheme for Registration uses assessment to fulfil different functions, including supporting and structuring trainees’ clinical progress, identifying strengths and weaknesses and acting as a licensing exam for an optometrist to pass before practising independently. The extent to which the Scheme maps to the concept of low-stakes and high-stakes assessment is explored, and the article describes how complementary methods of assessment can be used in a programme to combine assessment as learning with assessment of learning.