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Background: Clinical competency certifications are important parts of internal medicine residency training. This study aims to evaluate a composite objective structured clinical examination (OSCE) that assesses postgraduate year-1 (PGY 1 ) residents' acquisition of the six core competencies defined by the Accreditation council for Graduate Medical Education (ACGME). Methods: Six-core-competency-based OSCE was used as examination of the clinical performance of 192 PGY 1 residents during their 3-month internal medicine training between 2007 January and 2009 December. For each year, the reliability of the entire examination was calculated with Cronbach's alpha. Results: The reliability of six-core-competency-based OSCE was acceptable, ranging from 0.69 to 0.87 between 2007 and 2009. In comparison with baseline scores, the summary scores and core-competency subscores all showed significant increase after PGY 1 residents finished their 3-month internal medicine training program. Conclusion: By using a structured development process, the authors were able to create reliable evaluation items for determining PGY 1 residents' acquisition of the ACGME core competencies.
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