The Dundee Medical School has bean running OSCEs since 1977. In 1995, an integrated systems-based spiral curriculum on the core and options model was introduced. In 1997, outcome-based education was introduced as the basis for instruction, with a task-based educational strategy employed for students in years 4 and 5. This blend of educational strategies was considered in the design of the student assessment process. Assessment instruments, appropriate for use at each of the four levels of Miller's pyramid, were identified and included in the assessment process. The OSCE was used for summative assessment of students at the level of 'shows how' or simulation in years 2, 3 and 4. A year 2 OSCE is described here. Features of the Dundee OSCE are identified, relating to number and length of individual stations, practicalities or assessing a year group of students without student contamination with examination information and the blueprints used to design the examinations. Suggestions made for future development of the OSCE include the OSSE, the Objective Structured Selection Examination, and an exploration of the potential of the OSCE to assess attitudes, personal attributes and professionalism. The need is identified for a platform to debate issues such as should individual medical schools attempt to achieve national test centre standards with their examinations.