Abstract. Traditionally, medical education has used live patients to teach medical procedures. This carries a significant risk to patients. As learning technology advances, the early integration of computer-aided medical simulations into medical training before patient contact is becoming an ethical imperative, yet development costs are constraining. In this paper, we describe the use of a gaming engine to create rapidly a game-like interactive simulation for medical training at a low cost. Our process model, driven by the simulation storyboard provided by the instructors, allows for easy simulation refinements and permits an early evaluation of the educational outcome. We also describe its initial integration into the existing matrix of low-tech simulation (procedures practiced on mannequins) and an educational platform (e-learning system) used to support and track novice physicians within a large academic training center.