Assessment and feedback are important elements of medical education. Time logged on to the website and accessing the e-learning modules can be monitored as a part of formative assessment. Formative or summative assessments in e-learning courses can be carried out using Multiple Choice Questions and Extended Matching Questions. Multimedia enhanced virtual patient case scenarios can be used for assessment followed by Multiple Choice Questions or diagnostic reasoning tests. Care must be taken to include all possible correct answers in diagnostic reasoning tests because programming can be technically challenging. I have some reservations in using e-learning summative assessments as the identity of the student can not be guaranteed and may encourage cheating. Feedback in e-learning is limited to correction of mistakes and it is difficult to provide detailed feedback.Cook et al 2008 conducted a systematic review and meta-analysis of internet based instruction in medical education. They have concluded that e-learning is better than no intervention and as effective as traditional education. They have also concluded that there is no evidence to conclude that e-learning is better than traditional education. Clark 2002 has demonstrated that students are very satisfied with e-learning. Students, however, do not see e-learning replacing instructor-led training but as a complement to it, forming a part of a blended learning strategy.