Objective: The objective of this study was to explore osteopathy students' perceptions of occupational stress and clinical practice competence, and how these perceptions changed after six months of osteopathic practice. Participants: Students who graduated in 2010 from Victoria University's osteopathy program. Method: Participants completed one survey as final year osteopathy students in November 2010 and one survey as registered osteopaths in July 2011. The surveys were developed by drawing on previous work investigating health professional capabilities and also graduates transition to practice. Key areas of exploration were work related stressors and self-perceived clinical competence. Results: Job related stressors experienced were different from those expected by students, however, the overall level of stress as a new practitioner was accurately anticipated by students. New graduates were found to experience high levels of stress caused by: managing tricky patients; feeling like they should know everything; medico-legal issues; time management; and, overwork. Students in their final months of the osteopathy program felt more competent than after six months in practice. However, they perceived a lack of competence in: establishing a prognosis and using appropriate outcome measures; managing risks; maintaining * Corresponding author. College