Core Entrustable Professional Activities for Entering Residency

Core Entrustable Professional Activities for Entering Residency


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Number of pages:114
Year published:2014
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This landmark publication published by the AAMC identifies a list of integrated activities to be expected of all M.D. graduates making the transition from medical school to residency.  This guide delineates 13 Entrustable Professional Activities (EPAs) that all entering residents should be expected to perform on day 1 of residency without direct supervision regardless of specialty choice.

The Core EPAs for Entering Residency are designed to be a subset of all of the graduation requirements of a medical school. Individual schools may have additional mission-specific graduation requirements, and specialties may have specific EPAs that would be required after the student has made the specialty decision but before residency matriculation. The Core EPAs may also be foundational to an EPA for any practicing physician or for specialty-specific EPAs.

Update: In August 2014, the AAMC selected ten institutions to join a five-year pilot to test the implementation of the Core Entrustable Professional Activities (EPAs) for Entering Residency. More than 70 institutions, representing over half of the medical schools accredited by the U.S. Liaison Committee on Medical Education (LCME), applied to join the pilot, demonstrating the significant energy and enthusiasm towards closing the gap between expectations and performance for residents on day one. The cohort reflects the breadth and diversity of the applicant pool, and the institutions selected are intended to complement each other through the unique qualities and skills that each team and institution brings to the pilot.

The guide is available (described below) as a free PDF download.  

Curriculum Developers’ Guide (114 pages) - Free PDF or Print Version.

The EPA descriptions and the tables of competencies and milestones should serve as the basis for curriculum development. Schools intending to pilot these EPAs will need to address curriculum and assessment. Specific questions to address include:

  • How will the EPA be taught?
  • Where and when in the curriculum?
  • What will the content be?
  • Who will teach the EPA?
  • How will the EPA be assessed?
  • Who will make the entrustment decision?
  • How will the entrustment decision be made?

Faculty and Learners’ Guide (69 pages) - Free PDF or Print Version.

  • Developing faculty: The EPA descriptions, the expected behaviors, and the vignettes are expected to serve as the foundation for faculty development. Faculty can use this guide as a reference for both feedback and assessment in pre-clinical and clinical settings.
  • Developing learners: Learners can also use this document to understand the core of what is expected of them by the time they graduate. The EPA descriptions themselves delineate the expectations, while the developmental progression laid out from pre-entrustable to entrustable behaviors can serve as the roadmap for achieving them.