A recent editorial pointed out that the 'adding-value' feature of occupational physician (OP) activity as compared to allied professionals in preventing occupational risks is the clinical skill. It was argued that, apart from clinical skills, no difference exists between the risk manager and the OP in dealing with risk characterization and risk management. On the other hand, it is stressed that the practice of occupational medicine must be based on a sound professional competence including a basic clinical knowledge. Should the educational process of the specialist in occupational medicine include the acquisition of adequate clinical competence? Several reports dealing with education and training of OPs in Europe underline the need that this figure be a skilled clinician. This is necessary to investigate the occurrence of occupational and work-related diseases and to evaluate and control health status of workers who might be exposed to harmful factors.'' Elsewhere clinical skills are less emphasized'' or neglected. Outside Europe, the American College of Occupational and Environmental Medicine states that the mission of the OP is devoted to the prevention and management of occupational and environmental injury, illness and disability, promoting the health and safety of individuals and focusing diagnosis of illnesses and their rehabilitation.