This paper discusses a shift in medical education from focusing on individual patient interactions to addressing the structural forces that influence health outcomes. It proposes "structural competency," a framework that trains clinicians to recognize how social, economic, and institutional factors shape health and illness. The five core competencies include: 1) recognizing the structures that shape clinical interactions, 2) developing an extra-clinical language of structure, 3) rearticulating "cultural" formulations in structural terms, 4) observing and imagining structural interventions, and 5) developing structural humility. The paper argues that medical education must move beyond cultural competency to address the broader structural determinants of health, such as poverty, inequality, and systemic racism. It highlights the need for medical professionals to understand how social and economic forces impact health outcomes, and to develop skills that allow them to address these issues in clinical settings. The paper also emphasizes the importance of structural humility, recognizing the limitations of medical expertise and the need for collaboration with communities and social systems. Ultimately, the paper calls for a new approach to medical education that integrates structural competency into clinical training, enabling clinicians to better address health disparities and promote equity in healthcare.This paper discusses a shift in medical education from focusing on individual patient interactions to addressing the structural forces that influence health outcomes. It proposes "structural competency," a framework that trains clinicians to recognize how social, economic, and institutional factors shape health and illness. The five core competencies include: 1) recognizing the structures that shape clinical interactions, 2) developing an extra-clinical language of structure, 3) rearticulating "cultural" formulations in structural terms, 4) observing and imagining structural interventions, and 5) developing structural humility. The paper argues that medical education must move beyond cultural competency to address the broader structural determinants of health, such as poverty, inequality, and systemic racism. It highlights the need for medical professionals to understand how social and economic forces impact health outcomes, and to develop skills that allow them to address these issues in clinical settings. The paper also emphasizes the importance of structural humility, recognizing the limitations of medical expertise and the need for collaboration with communities and social systems. Ultimately, the paper calls for a new approach to medical education that integrates structural competency into clinical training, enabling clinicians to better address health disparities and promote equity in healthcare.