Since 1971 the directors of residency training programs in internal medicine have had the responsibility for evaluating the clinical skills of their trainees for the American Board of Internal Medicine. Satisfactory performance is required by the board as a qualification for admission to its written certifying examination. This report presents the board's experience with the evaluation of clinical skills through June 1975 based on visits with the administrators of 166 residency training programs. Described are the evaluative methods employed by the programs, the delineation and observation of acceptable minimum standards of performance, and the benefits to training in internal medicine accruing from the institution of these evaluation procedures and from the related visits to hospitals by representatives of the board.