Among these innovative approaches, ECOSM, the equivalent of ECOS, was introduced at the Tunis Faculty of Medicine in 1998. This system is based on a series of stations where participants must solve specific cases within predefined timeframes. Each station aims to assess mastery of key skills by breaking them down into individually assessable tasks, thus encompassing the areas of knowledge, know-how and even interpersonal skills.Acclaimed for its effectiveness, reliability and relevance in the context of clinical assessment, the ECOSM is a fair and authentic instrument for formative and normative evaluation. Despite its success in other contexts, no research has yet been carried out on its specific application in pathological anatomy.