Self assessment accuracy is an essential precursor to the development of self-directed learning- a desired goal of medical education. The purpose of this study was to determine medical students’ long term accuracy of performance prediction, evaluated in the context of formative assessments designed to provide practice for the summative assessment. Students were asked to predict their performance on the final exam over six formative assessments and at the end of the final exam. Students’ confidence levels were predictive of near assessments, but were uncorrelated with final exam performance. Moreover, the ratings were stable over time. These findings are discussed in context of medical students’ approach to learning in the second year of medical school.