Matching assessment strategies to learning outcomes in radiation therapy education is of the utmost importance. Assessing clinical competence requires that ‘competence’ be clearly defined prior to the start of any clinical programme. In this article, we report on our experience in using clinical oral examinations in assessing competence in second year undergraduate radiation therapy students. The shortcomings of clinical oral examinations such as ‘leaking’ of the agenda are addressed and more positive attributes, such as increased collaboration between academic and clinical radiation therapists are discussed.