Abstract This study investigates the perceptions and expectations of internship students participating in the Outcome-Based Medical Education (OBME) program at the Defence Services Medical Academy (DSMA) in Myanmar. A mixed-methods approach, incorporating both quantitative and qualitative data, was employed to explore students' experiences. The Dundee Ready Education Environment Measure (DREEM) questionnaire was used to assess students' perceptions of their educational environment, while in-depth interviews and focus group discussions provided deeper insights into their challenges and expectations. The findings indicate that students generally have a positive perception of the educational environment, with an overall DREEM score of 130 out of 200. However, significant challenges were reported in transitioning from a traditional curriculum to OBME, particularly in adapting to new learning methodologies and assessment strategies. Faculty support and peer interaction were identified as critical factors in helping students navigate the program, though some students faced social challenges. Additionally, a gap between students' expectations and their actual experiences, especially regarding workload and assessments, was observed. The study highlights the need for enhanced faculty development, improved communication, and better support systems to address the identified challenges. The findings provide valuable insights for improving the OBME program at DSMA and contribute to the broader field of medical education by offering empirical data from the context of a military medical academy. Recommendations for future research include longitudinal studies and expanding the scope of research to other institutions. Keywords: Defence Services Medical Academy, Outcome-based Medical Education , DREEM , Student- centred learning , Faculty development