Medical training has increasingly focused on standardization to improve communication and reduce medical errors. In gastroenterology training programs, the need for clear interpersonal communication is heightened by the high acuity of patients and the frequent use of a home call system. We sought to assess important yet largely unevaluated skill sets based on system-based practice milestones outlined by Accreditation Council for Graduate Medical Education requirements using an Observed Standardized Clinical Examination (OSCE).