Preface As physicians’ clinical skills cannot be measured solely by written examination, a National objective structured clinical examination (OSCE) has been considered necessary as a part of medical licensure examination. By the end of 2008, about 20 medical centers/ hospitals in Taiwan announced that OSCE has been a regular clinical examination for their trainees. However, there is little consensus about how to implement a high-stake, large scale OSCE. The Medical Council of Canada (MCC) has administered an OSCE for the license to practice medicine since 1992. The high stake, large scale OSCE is to test physicians’ skills of history taking, physical examination, and communication. The examination results with psychometric evidence indicate that a full-scale national administration of an OSCE model for licensure is feasible in Canada. Dr. Sydney Marla Smee is currently the Manager of MCCQE Part II, Evaluation Bureau Medical Council of Canada (1990-Present). She is an internationally recognized expert in implementing a high stake OSCE. The workshop in Taiwan lead by Dr. Smee is to facilitate the establishment of a Taiwanese model of high stake OSCE. 1