Assessment of a doctor's or student's clinical competence is of key importance. The examiner should ask what competencies he is attempting to assess and how he can best assess them; whether, for example, by using an objective structured clinical examination (OSCE), patient management problems (PMP), supervisors' reports, project work or assignments, or by auditing case records. He should consider the functions of the clinical examination, in particular its role in providing feedback to the student and teacher. With regard to timing there is a place for both in-course and end-of-course assessment of clinical competence. Finally, in considering who should undertake the assessment, the role of the student or doctor in assessing his own competence should not be overlooked.