Core Entrustable Professional Activities for Entering Residency : Curriculum Developers' Guide

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Program directors have increasingly expressed concern that some medical school graduates are not prepared for residency. While most schools have “graduation competencies” or “graduation objectives” that are linked to foundational competencies and to the unique mission of the school, there has been no agreement in the undergraduate medical education community about a common core set of behaviors that should be expected of all graduates.

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.

Two versions of the guide are available: a Curriculum Developer’s Guide and a Faculty and Learner’s Guide.

In this Curriculum Developers’ Guide, 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?