Introduction Due to the Covid-19 pandemic and associated travel restrictions, the physical presence of international external examiners was a challenge when assessing the exit level outcomes of the MSc (Dent) in Paediatric Dentistry at the University of the Western Cape.External moderation of final examinations ensure an acceptable standard, coverage of content as specified by the programme outcomes and eliminates bias during assessment. Internationalization of the moderation and examination process allows countries to compare and maintain international standards and graduate attributes expected for professional qualifications. Qualifications requiring assessment of skills often rely on Objective Structured Clinical Examinations, Objective Structured Practical Examinations and simulated cases in combination with an oral examination, which requires the presence of all examiners to assess the student.Aims and objectives This paper describes how the final examination in this MSc (Dent) degree was adapted and conducted in order to overcome the challenges of the Covid-19 pandemic, to maintain the academic integrity and rigour of the programme.Design and Methods A narrative essay-style approach was adopted, which reflects on the challenges and opportunities created by Covid-19.Conclusion The adapted assessment method proved to be an effective alternative to the more traditional assessment approaches employed pre-Covid.