In 2014, the Association of American Medical Colleges (AAMC) published a list of 13 Core Entrustable Professional Activities for Entering Residency (Core EPAs) that medical school graduates might be expected to perform, without direct supervision, on the first day of residency. Soon after, the AAMC commissioned a five-year pilot with 10 medical schools across the United States, seeking to implement the Core EPA framework to improve the transition from undergraduate to graduate medical education.
In this article, the pilot team presents the organizational structure and early results of collaborative efforts to provide guidance to other institutions planning to implement the Core EPA framework. They describe the aims, timeline, and organization of the pilot as well as findings to date regarding the concepts of entrustment, assessment, curriculum development, and faculty development. On the basis of their experiences over the first two years of the pilot, the authors offer a set of guiding principles for institutions intending to implement the Core EPA framework. They also discuss the impact of the pilot, its limitations, and next steps, as well as how the pilot team is engaging the broader medical education community. They encourage ongoing communication across institutions to capitalize on the expertise of educators to tackle challenges related to the implementation of this novel approach and to generate common national standards for entrustment. The Core EPA pilot aims to better prepare medical school graduates for their professional duties at the beginning of residency with the ultimate goal of improving patient care.
K. Lomis is associate dean for undergraduate medical education and professor of surgery, Vanderbilt University School of Medicine, Nashville, Tennessee.
J.M. Amiel is associate dean for curricular affairs and associate professor of psychiatry, Columbia University College of Physicians and Surgeons, New York, New York.
M.S. Ryan is assistant dean for clinical medical education and associate professor of pediatrics, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
K. Esposito is associate dean for curriculum and medical education and professor and vice chair of psychiatry and behavioral health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida.
M. Green is professor of medicine and director for student assessment, Yale School of Medicine, New Haven, Connecticut.
A. Stagnaro-Green is regional dean and professor of medicine, obstetrics and gynecology, and medical education, University of Illinois College of Medicine, Rockford, Illinois.
J. Bull is lead specialist in competency-based learning and assessment, Association of American Medical Colleges, Washington, DC.
G.C. Mejicano is senior associate dean for education and professor of medicine, Oregon Health & Science University School of Medicine, Portland, Oregon.
Funding/Support: This work was supported by the Association of American Medical Colleges and by the medical schools participating in the Core Entrustable Professional Activities for Entering Residency pilot.
Other disclosures: None reported.
Editor’s Note: An Invited Commentary by Th.J.(Olle) ten Cate appears on pages 736–738.
Ethical approval: Reported as not applicable.
Previous presentations: Preliminary work from the Core Entrustable Professional Activities for Entering Residency pilot was presented during a poster session at the 2015 Association of American Medical Colleges Medical Education meeting, Baltimore, Maryland.
Correspondence should be addressed to George C. Mejicano, Oregon Health & Science University School of Medicine, Mail Code: L102, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239; telephone: (503) 494-6074; e-mail: firstname.lastname@example.org; Twitter: @GeorgeMejicano.