OSCEs are outdated: clinical skills assessment should be centred around workplace-based assessments (WPBAS) to put...

This article was migrated. The article was marked as recommended. OSCEs have gradually replaced 'long cases' as the mainstay of undergraduate clinical skills assessment because of their objectivity, consistency and reliability. But the aspects of OSCEs which make them so reliable increasingly encourage students to prepare strategically, who often adopt a robotic 'tickbox' approach, rather than use OSCEs as a tool to learn clinical skills for safe competent real-life practice. Thus, whilst OSCEs facilitate technical competence, they do not prepare students for the unique nuances that make medicine an 'art' as well as a science. In pursuit of consistency and reliability, we are sacrificing validity and not preparing future doctors for the innate nuances and variability that make medicine so unique- and which often come as a shock to newly qualified doctors who orientate their undergraduate learning around OSCEs rather than real life. The doctors of the future will need to be adaptable and be able to vary their practice depending on the clinical and biopsychosocial context much more so than before. To drive their learning accordingly, we need a paradigm shift in medical education and assessment. WPBAs should now take centre-stage in undergraduate clinical assessment, with OSCEs significantly scaled back.