OSCE examinations were held in May and June 2002 for all third and fourth year and some fifth year medical students at the University of Leeds. There has been an arbitrary pass mark of 65% for these examinations. However, we recognise that it is important to adopt a systematic approach towards standard setting in all examinations so held a trial of the borderline approach to standard setting for third and fifth year examinations. This paper reports our findings. The results for the year 3 OSCE demonstrated that the borderline approach to standard setting is feasible and offers a method to ensure that the pass standard is both justifiable and credible. It is efficient, requiring much less time than other methods and has the advantage of using the judgements of expert clinicians about actual practice. In addition it offers a way of empowering clinicians because it uses their expertise.