Entrustable Professional Activities (EPAs)

An EPA is a key task of a discipline that an individual can be trusted to perform without direct supervision in a given health care context, once sufficient competence has been demonstrated.  Each EPA typically consists of multiple milestones.

You can download all of the Internal Medicine EPAs here. 

Transition to Discipline

D1 Performing histories and physical exams, documenting and presenting findings, across clinical settings for initial and subsequent care
D2 Identifying and assessing unstable patients, providing initial management, and obtaining help
D3 Performing the basic procedures of Internal Medicine

Foundations of Discipline 

F1 Assessing, diagnosing, and initiating management for patients with common acute medical presentations in acute care settings
F2 Managing patients admitted to acute care settings with common medical problems and advancing their care plans
F3 Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan
F4 Formulating, communicating, and implementing discharge plans for patients with common medical conditions from acute care settings
F5 Assessing unstable patients, providing targeted treatment and consulting as needed
F6 Discussing and establishing patients' goals of care
F7 Identifying personal learning needs while caring for patients and addressing those needs

Core of Discipline

C1 Assessing, diagnosing and, managing patients with complex or atypical acute medical presentations
C2 Assessing and managing patients with complex chronic conditions
C3 Providing internal medicine consultation to other clinical services
C4 Assessing, resuscitating, and managing unstable and critically ill patients
C5 Performing the procedures of Internal Medicine
C6 Assessing capacity for medical decision-making
C7 Discussing serious and/or complex aspects of care with patients, families, and caregivers
C8 Caring for patients who have experienced a patient safety incident (adverse event)
C9 Caring for patients at the end of life
C10 Implementing health promotion strategies in patients with or at risk for disease
C11 Supervising junior learners in the clinical setting

Transition to Practice

P1 Managing an inpatient medical service
P2 Managing longitudinal aspects of care in a medical clinic
P3 Assessing and managing patients in whom there is uncertainty in diagnosis and/or treatment
P4 Providing consultation to off-site health care providers
P5 Initiating and facilitating transfers of care through the health care system
P6 Working with other physicians and healthcare professionals to develop collaborative patient care plans
P7 Identifying learning needs in clinical practice, and addressing them with a personal learning plan
P8 Identifying and analyzing system-level safety, quality or resource stewardship concerns in healthcare delivery