Medical students and residents have lower rates of error reporting than other staff groups. As a result, medical schools now include curricula on identifying system failures and reporting them through existing reporting structures. This study assessed 5 years of medical student descriptions of adverse events, whether they felt an incident report was required, and their rationale for not submitting one. Students indicated that only 18% of adverse events would require reporting, with a common rationale of no harm reaching the patient, i.e., a near miss.