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Internal Medicine Residency Program Directors’ Views of the Core Entrustable Professional Activities for Entering Residency: An Opportunity to Enhance Communication of Competency Along the Continuum

Angus, Steven V. MD; Vu, T. Robert MD; Willett, Lisa L. MD, MACM; Call, Stephanie MD, MSPH; Halvorsen, Andrew J. MS; Chaudhry, Saima MD, MSHS

doi: 10.1097/ACM.0000000000001419
Research Reports

Purpose To examine internal medicine (IM) residency program directors’ (PDs’) perspectives on the Core Entrustable Professional Activities for Entering Residency (Core EPAs)—introduced into undergraduate medical education to further competency-based assessment—and on communicating competency-based information during transitions.

Method A spring 2015 Association of Program Directors in Internal Medicine survey asked PDs of U.S. IM residency programs for their perspectives on which Core EPAs new interns must or should possess on day 1, which are most essential, and which have the largest gap between expected and observed performance. Their views and preferences were also requested regarding communicating competency-based information at transitions from medical school to residency and residency to fellowship/employment.

Results The response rate was 57% (204/361 programs). The majority of PDs felt new interns must/should possess 12 of the 13 Core EPAs. PDs’ rankings of Core EPAs by relative importance were more varied than their rankings by the largest gaps in performance. Although preferred timing varied, most PDs (82%) considered it important for medical schools to communicate Core EPA-based information to PDs; nearly three-quarters (71%) would prefer a checklist format. Many (60%) would be willing to provide competency-based evaluations to fellowship directors/employers. Most (> 80%) agreed that there should be a bidirectional communication mechanism for programs/employers to provide feedback on competency assessments.

Conclusions The gaps identified in Core EPA performance may help guide medical schools’ curricular and assessment tool design. Sharing competency-based information at transitions along the medical education continuum could help ensure production of competent, practice-ready physicians.

Supplemental Digital Content is available in the text.

S.V. Angus is internal medicine residency program director and vice chair of education, Department of Medicine, University of Connecticut School of Medicine, Farmington, Connecticut.

T.R. Vu is associate professor of clinical medicine and associate director of internal medicine clerkships, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.

L.L. Willett is internal medicine residency program director and vice chair of education, Department of Medicine, University of Alabama, Birmingham, Birmingham, Alabama.

S. Call is associate chair for education and program director, Internal Medicine Training Program, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia.

A.J. Halvorsen is project and data manager, Office of Educational Innovations, Internal Medicine Residency Program, Mayo Clinic, Rochester, Minnesota.

S. Chaudhry is vice president for academic affairs and chief academic officer, Memorial Healthcare System, Fort Lauderdale, Florida.

Supplemental digital content for this article is available at

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: This study was approved by the Mayo Clinic institutional review board.

Correspondence should be addressed to Steven V. Angus, Department of Medicine, University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030; e-mail:

© 2017 by the Association of American Medical Colleges