ObjectiveConduct a scoping review of medical student competency assessment research to provide a reference for constructing a scientific, practical, and feasible assessment system. MethodsThe search was conducted in CNKI, SinoMed, WanFang Data, PubMed, Web of Science and Embase databases. The time limit was set from the inception to June 2025. A scope review was conducted based on Arksey and O’Malley’s framework of scope definition review methods. ResultsA total of 31 studies were included, involving 13 theoretical, 6 empirical, and 12 mixed-methods. These studies reported on mainstream competency assessment methods in medical education, such as the objective structured clinical examination, 360-degree evaluation, mini-clinical assessment (MCA), multiple-choice questions (MCQs), and direct observation of procedural skills. Studies on competency model construction primarily used the Miller pyramid, Bloom’s taxonomy of educational objectives, and the current physician competency consensus as core theoretical frameworks. Mixed research methods, such as literature analysis, behavioral event interviews, the Delphi method, and questionnaire surveys, were frequently employed. Domestic competency models primarily focused on "knowledge, skills, and professionalism" as core indicator elements, with the five-point Likert scale being the predominant format for questionnaire items (8 items, 57.1%). Although research reliability validation was relatively well-established, More than half of the studies (7 items, 53.8%) did not report validity metrics. Conclusion While theoretical foundations in competency research are well-established and modeling methodologies are diverse, current assessment methods face limitations, and a lack of uniformity persists in the core elements of competency models. Competency models developed domestically and internationally exhibit significant differences in dimension categorization and item quantity.