While osteopathic and allopathic medicine share many commonalities, there are key practice-based differences that uniquely characterize the two professions. For osteopathic medicine, one such defining feature is the use of osteopathic manipulative treatment (OMT). Unfortunately, while various treatment modalities are taught in osteopathic medical schools, there has been relatively little work done to establish standardized evaluation protocols. The purpose of this investigation was to explore the use of OMT assessment in the context of a multistation standardized patient examination. Analysis of performance data from 121 fourth-year osteopathic medical students indicated that the ability to do OMT can be reliably and validly assessed using a combination of simulated patient encounters, trained osteopathic physician raters, and an objective rating tool. Additional studies that incorporate a larger sample of students and focus on modifications to the assessment tool and rating protocols are warranted.