The Seventh Competency

Background: Disclosure of error is gaining acceptance as an ethical imperative in health care. Despite this, residency training programs do not commonly address this in their curricula, and competence in the identification and disclosure of adverse events and medical error is typically not assessed. Summary: Although aspects of the identification, disclosure, and apology for medical error can be subsumed under existing competencies, the skills required in this area are in many ways fundamentally different from anything else physicians are taught. Conclusions: We propose that the identification of medical error recognition and disclosure be recognized as a seventh core competency and we suggest that residency program directors be invited to develop innovative approaches to teaching and assessing competence in this area. This will benefit training programs, residents, and ultimately society and the patients that we serve.