How are clinicians to preserve core clinical skills in an era of algorithmic assistance? As artificial intelligence (AI) assumes a growing role in clinical practice, concern is mounting that off-loading clinical tasks and reasoning will lead to loss of skills (deskilling), adopting errors or bias from AI (mis-skilling), or failure to achieve competence (never-skilling; figure). Evidence for such skill attrition has been seen with automated interpretation of electrocardiograms or radiological images. An observational study published earlier this year, however, sharpens this concern, suggesting that experienced colonoscopists lost some proficiency in colon polyp detection when routine AI support was switched off.