Introduction PhysiciansareunderthepledgetofollowtheHippocratic Oath of "first do no harm". However, the report from InstituteofMedicinein1999,"Toerrishuman:Buildinga Safer Health System", showed that much harm is being done by medical errors. 1 According to the report, around 98,000 people may be dying every year due to medical errors in hospitals of the United States. This number was more than deaths due to road traffic accidents (RTAs), breast cancer, or acquired immunodeficiency syndrome (AIDS),causeswhichreceivemuchwiderpublicattention. If we add the financial burden, these huge mortality figuresmakemedicalerroroneofthemosturgentpublic healthproblems. 2 Significant improvement in healthcare has occurred as a result of advances in medical science and technology. However, this improvement has come at the cost of patientsafety,aspatientsincreasinglysufferfromadverse events due to hospitalisation and medical management. In response to this situation, 'patient safety' has emerged as a new specialised discipline which can help health professionalsdevelopacultureofpatientsafety. 3 It has been suggested that the healthcare system should learn from the aviation experience which, by implementing a system-based and team-based management approach, has successfully developed a cultureofairtravelsafety. 4 Traditionally, medical error has been blamed on a person error. This approach, by naming, blaming, and shaming individuals, may be psychologically more satisfying for administrations as it absolves the institutions from any responsibility.Itfocusesattentiononunsafeactsoractive failures of people at the sharp end (nurses, trainees, doctors, pharmacists etc.) and attributes these to human factors e.g. forgetfulness, poor motivation, carelessness, and negligence. On the other hand, the "systems approach" is based on the premise that humans are fallible and will make errors in the best of institutions. Errors are actually related to weaknesses in the defence system, including factors like time pressures, understaffing, prolonged duty hours, sleep deprivation and their consequent physical, mental, and emotional fatigue.The key, therefore, lies in improving the working conditionsorthesystemdefenceastheimportantissueis not about who did it, but how and why the system JPakMedAssoc 1261 ORIGINAL ARTICLE Patient safety: Perceptions of Medical Students of Dow Medical College, Karachi NusratShah, 1 MasoodJawaid, 2 NighatShah, 3 SyedMoynAli 4 Abstract Objective: To assess medical students' perceptions about patient safety issues before the teaching of "patient safety"canberecommended. Methods: The cross-sectional survey was undertaken at the Dow Medical College and Civil Hospital, Karachi, in September, 2013. Data collection tool was a structured questionnaire administered to medical students.The main outcome measures were students' perceptions about patient safety issues and their attitude towards teaching of patientsafetycurriculum. Results: There were 229 medical students in the study with a response rate of 100%. Overall, 129(57%) students agreedthatmedicalerrorswereinevitable,but106(46.9)thoughtcompetentphysiciansdonotmakeerrors.While 167(74%) students said medical errors should be reported, 204(90%) thought reporting systems do not reduce future errors. Besides, 90(40%) students thought only physicians can determine the causes of error and nearly 177(78%)% said physicians should not tolerate uncertainty in patient care. Overall, 217(96%) agreed that patient safetyisanimportanttopic;210(93%)agreedthatitshouldbepartofmedicalcurriculum;197(87%)saidtheywould liketolearnhowtodisclosemedicalerrorstopatientsand203(90%)tofacultymembers. Conclusion: A significant knowledge gap existed among medical students regarding patient safety issues. The teachingof'patientsafety'washighlysupportedbystudentsandneedstobeincludedinmedicalcurriculumonan urgentbasis. Keywords: Patientsafety,Medicalerror,UndergraduateMedicalCurriculum,Pakistan.(JPMA65:1261;2015) 1 Department of Obstetrics & Gynecology, Dow University of Health Sciences, Karachi, 2 Department of Surgery, Dow International Medical College, Karachi, 3 Department of Ob-Gyn, Aga Khan University Hospital, Karachi, Pakistan, 4 Department of Medical Education, College of Medicine, Taif University, Saudi Arabia. Correspondence: Nusrat Shah. Email: nusrat61@gmail.com