Abstract: Courses assessment is an important teaching step in the higher medical education process. The assessment result always be used as an essential indicator for the evaluation of entire education process and the quality of teaching. This article mainly focused on the building of medical education item bank which had been used in the courses assessment. Firstly, the significance of medical education item bank was elaborated; and then the general problems were explored; furthermore, their causes were analyzed; lastly, the countermeasures to those problems were presented to set up the basic approach to medical education item bank building.