A new set of guidelines from the AAMC (Association of American Medical Colleges) will help bridge the gap between patient care activities that new physicians should be able to perform on day one of residency training, and those they feel ready to perform without direct supervision. With the goal of improving patient care and safety, the guidelines are the first formal outline of the activities and requisite competencies and behaviors that every graduating medical student should be able to perform upon entering residency.
"As the nation's medical school graduates prepare to begin their residency training in July, ensuring they have the confidence to perform these activities is critical for clinical quality and safety," said AAMC President and CEO Darrell G. Kirch, M.D. "These guidelines take medical education from the theoretical to the practical as students think about some of the real-life professional activities they will be performing as physicians."
Working with a group of graduate medical education experts, the AAMC developed the Core Entrustable Professional Activities (EPAs) for Entering Residency in response to feedback from residency program directors about the clinical preparedness of entering residents, and from emerging literature documenting a performance gap at the transition point between medical school and residency training. The guidelines include 13 activities that all medical students should be able to perform, regardless of specialty, to standardize the expectations for both learners and teachers and better prepare students for their roles as clinicians. The core EPAs—which include activities such as gathering a patient history, prioritizing differential diagnoses, and recommending tests—were chosen as the framework for the guide because they offer a promising approach for assessing the real-world impact of a resident physician's education on patient care.
The guidelines describe expected behaviors and provide clinical vignettes demonstrating how new residents ready to be entrusted for performance without direct supervision would handle each of the specific EPAs. This summer, the AAMC will engage a few medical schools to launch a multi-year pilot and develop a learning community to share ideas about how the EPAs can be broadly implemented.