An Entrustable Professional Activity (EPA)-Based Framework to Prepare Fourth-Year Medical Students for Internal Medicine Careers

D. Michael Elnicki, Meenakshy K. Aiyer, Maria L. Cannarozzi, Alexander Carbo, Paul R. Chelminski, Shobhina G. Chheda, Saumil M. Chudgar, Heather E. Harrell, L. Chad Hood, Michelle Horn, Karnjit Johl, Gregory C. Kane, Diana B. McNeill, Marty D. Muntz, Anne G. Pereira, Emily Stewart, Heather Tarantino, T. Robert Vu

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies. The authors propose a curricular framework based on five CEPAERs that were felt to be most relevant to residency preparation, informed by prior stakeholder surveys. The critical areas outlined include entering orders, forming and answering clinical questions, conducting patient care handovers, collaborating interprofessionally, and recognizing patients requiring urgent care and initiating that care. For each CEPAER, the authors offer suggestions about instruction and assessment of competency. The fourth year of medical school can be rewarding for students, while adequately preparing them to begin residency, by addressing important elements defined in the core entrustable activities. Thus prepared, new residents can function safely and competently in supervised postgraduate settings.

Original languageEnglish (US)
Pages (from-to)1255-1260
Number of pages6
JournalJournal of general internal medicine
Issue number11
StatePublished - Nov 1 2017

Bibliographical note

Publisher Copyright:
© 2017, Society of General Internal Medicine.


  • clinical skills assessment
  • medical education
  • medical education curriculum development/assessment
  • medical education—assessment
  • medical education—mentoring
  • medical education—undergraduate


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