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Background: The COVID-19 pandemic had a profound impact on how our university had to administer the high stakes, final year medical undergraduate clinical examinations without real patients, while maintaining its validity and rigour Method: 11 out of the 21 stations of the medical, surgical and orthopaedic clinical examinations needed to be converted to simulated patient (SP)-based or task-based stations Cases were developed based on an assessment blueprint, with consideration for SP demographics and availability of equipment Infection control measures were strictly enforced to avoid transmission of COVID-19 Planning had to include consideration for physical distancing, cohorting and segregation of students and examiners Student and SP anxiety had to be addressed Results: The examination was executed successfully for 300 medical students Everyone worked professionally and dealt with the changes and precautions that were required with flexibility Discussion: An infectious disease outbreak can derail plans for major clinical examinations Factors that facilitated a rapid and effective response included decisive leadership, open communication, willingness to collaborate, mobilising resources, adaptability and flexibility Our school managed uncertainty by erring on the side of caution This experience may serve as a reference for others in similar situations, particularly when COVID-19 restrictions start to be lifted © Author(s) (or their employer(s)) 2020 No commercial re-use See rights and permissions Published by BMJ
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