Great article, Adam. I agree that clinical assessment and clinical diagnosis are important and rewarding, and that they’re under-represented in the current MRCGP examination. What can also be challenging and stimulating is the issue of ‘prognosis’ in the consultation. As GPs, we may not always be able to come up with an exact diagnosis, but I find we always have to decide whether a clinical presentation is likely to be serious or not – without immediate access to high-end investigations. Developing the confidence and skills to reassure patients based on clinical assessment, looking for red flags and dealing effectively with uncertainty are what I feel also make general practice exciting, taxing…and, if we take every clinical presentation seriously, never dull. The outcome of a GP consultation may also depend on the doctor as a person – showing interest in your patient, going the extra mile (or, in some cases, marathon), and bringing in your personality. So I agree, the MRCGP should put more emphasis on clinical examination and diagnosis – as well as prognosis. Looking to see what we could learn and adapt from the MRCP would be a good start.