ABSTRACT
Background: In 2011, Osaka University abolished the paper–based final examination at the end of 6th year of medical school and introduced a new examination that evaluates comprehensive clinical competency after clinical training.<br>Method: For this examination, sequential scenarios were developed that demonstrate the process of problem solving in patient care. The examiners administered an oral test to students using the scenarios in the same manner as ward rounds and evaluated the clinical competency of students according to their attitudes, knowledge, and thinking.<br>Results: The examination was administered smoothly. Eighty–nine percent of examiners and 59% of students affirmed the significance of the examination in a questionnaire.<br>Discussion: Our reform of the final examination was met with acceptance, especially by examiners. To assess clinical competency more accurately, our next goal is to integrate performance–based assessment into the sequential scenarios..