In each year of the MD program, students participate in skills-based examinations called Objective Structured Clinical Examinations (OSCE). OSCEs are the primary method for assessing clinical skills. The OSCE consists of medical scenarios with simulated patients in mock exam rooms.

For each scenario, students are asked to perform particular tasks (such as obtaining a patient history, performing a focused exam, perform clinical task, etc.). Students are rated by faculty member, specifically trained standardized patient, or other expert observer and performance is judged in comparison to a standard set of observable behavior criteria.

As a graduation requirement, all students must pass a senior comprehensive OSCE. These cases cover all areas of ambulatory care (e.g., emergency medicine, surgery, pediatrics, obstetrics, gynecology, psychiatry, and general medicine). Students are expected to perform as if they were a recent M.D. graduate of UNMC covering the practice of a family physician in a community of 30,000 individuals. Multiple specialists may be available for consultation, but in general the student is expected to take care of all the medical problems.

The M4 OSCE also incorporates the performance of one or more of the procedures on the UNCOM list of Clinical Skills Required for Graduation. Each case may require a student to do a limited history and/or physical examination, differential diagnosis, and request further evaluation. A minimum performance will be required to pass each case.