The author is involved in the management of Objective Structure Clinical Examination (OSCE) for Common Achievement Tests to be implemented prior to a clinical clerkship. In this study, we discuss how to develop questions for students who will receive OSCE after a clinical clerkship, as well as potential challenges in the introduction and management of its examination system. Finally, we consider the short-term future of clinical education, given the actual situation where a specialty-specific accreditation system has been introduced according to global standards, and medical education focused on medical professionalism is being offered.