Clinical communication skills are at the heart of medical practice, and poor performance is an important factor in the origins of complaints and litigation.1 2 A recent study from Canada shows that poorly performing doctors can be identified early in their careers and possibly given targeted support and appropriate further training.3

Tamblyn and colleagues followed up a cohort of newly qualified doctors in Ontario and Quebec for two to 12 years.3 They found a link between both communication and quality of care scores on the clinical skills examination of the Medical Council of Canada (taken shortly after graduation) and subsequent complaints registered with the medical regulatory authorities. A decrease of two standard deviations in communication score on the examination was associated with one additional complaint per 100 years of practice. People whose scores of communication skills were in the bottom quartile had a significantly increased risk of subsequent complaints from patients (excess complaint rate 2.15 per 100 practice years compared with the three other quartiles).

Although the rate of complaints per 100 years might seem low, complaints were …