Prior to the 20th century, Prognosis was one of the “big three” clinical skills of doctors, along with Diagnostics and Therapeutics. But due to advances in medical science in the past 100 years, many previously fatal conditions became curable, making Prognosis less relevant than the other two. As a result doctors have become deskilled in how to prognosticate. Palliative care has been part of the renewed interest in the ‘care of the incurables’ that has arisen over the past 30-40 years. With this renewed interest, there has been resurgence in prognostication but it is mostly limited to predicting the remaining time to death. Certainly, such predictions are important, for various reasons: patients and families may want this information to make their plans; clinicians may need it for medical decision making; researchers incorporate it in the design and analysis of studies; and regulators may want require it, as is the case in the USA with the ‘hospice benefit’. As a result, a large body of research on predicting survival now exists in the palliative care literature. But “how long have I got” is just one of many prognostic questions that need to be answered. In fact, Prognosis is a branch of clinical epidemiology and is more broadly defined as “the prediction of the various outcomes of the natural history/clinical course of an illness”. Reflecting on one’s daily interactions with patients, colleagues and administrators, it soon becomes apparent clinicians spend much of their time making predictions on a broad range of topics. The so-called “5 D’s of prognosis” is a useful framework for approaching the types of predictions we have to make: Death; Disease progression/recurrence; Disability/discomfort; Drug toxicity; and Dollars (cost). Some research has been done on predicting these other outcomes in palliative care but much more needs to be done. Be it death or some other outcome that is being predicted, clinicians need to develop competency across three domains to be proficient prognosticators: (i) making the prediction; (ii) communicating the prediction; (iii) using the prediction wisely. This presentation will discuss the knowledge, skills and attitudes 21st century doctors need to be competent prognosticators.