Many medical schools state that empathy is important and have curricular learning outcomes covering its teaching. It is thought to be useful in team-working, good bedside manner, patient perspective taking, and improved patient care. Given this, one might expect it to be measured in assessment processes. Despite this, there is relatively little literature exploring how measures of empathy in final clinical examinations in medical school map onto other examination scores. Little is known about simulated patient (actors) rating of empathy in examinations in terms of inter-rater reliability compared with clinical assessors or correlation with overall examination results.