The article describes three cases of patients where insufficient clinical examination led to an incorrect diagnosis. An elderly woman with osteoporosis after a fall was diagnosed in the emergency department as a muscle strain, although she had transient urinary incontinence, spinal tenderness, hip flexor weakness, and knee hyperreflexia, suggestive of a vertebral fracture. A patient with asthma, heart failure, and recent hernia surgery was evaluated by a pulmonologist as normal, but later presented with heart failure and symptoms of perforated bowel. An elderly man with hypoxia, hypotension, and dullness on back percussion was mistreated as heart failure in the emergency department, although he had multilobar pneumonia from which he died. The author emphasizes that modern medical training neglects clinical skills, especially physical examination, which threatens patient safety. The school system allows graduates to progress without mastery of basic skills such as distinguishing pneumonia from effusion, abdominal catastrophes, fractures or sepsis. The author proposes a radical rethinking of the assessment and progression of medical students.