Background: Evaluating clinical competency without jeopardizing patient safety is a challenge in residency education. Simulation Medicine is becoming a more integral part of Emergency Medicine residency education; however its effectiveness in assessing resident clinical skills for independent practice has not been validated. Purpose: We set out to demonstrate the effectiveness of simulation medicine in evaluating clinical competency. Methods: First through third year Emergency Medicine Residents at Darnall Army Community Hospital were given end of the year clinical evaluations by Staff Emergency Medicine physicians using patient simulators to evaluate basic Emergency Medicine care based on year of training. First,second and third year Emegency Medicine Residents were evaluated using patient simulators on basic Emegency Medicine care based on year of training. At the end of the simulation lab, 19 residents and 5 staff physicians were given confidential survey regarding how effective they felt the simulated patients were in evaluating clinical skills on a scale from 1–5 (1=poor, 2=fair, 3=good, 4=very good, and 5-excellent). Results: Staff Emergency Medicine physicians felt their evaluation of residents on simulated patients had good correlation with what they see on actual clinical shifts, with a mean survey score of 3.33. Residents also felt simulated patients were very good in evaluating their clinical skills, with a mean score of 4.05 (3.70–4.40, 95% confidence interval). Residents and staff both found the end of the year Simulation Day lab to be a fair way to evaluate clinical competency skills, with mean scores of 4.05 (3.82–4.29, 95% confidence interval) and 4.6, respectively. Conclusion: Residents and staff feel patient simulators serve as a useful tool in end of year clinical evaluation of competency. Conflict of Interest: Authors indicated they have nothing to disclose.