Since 2019 and based on the recommendations of The Royal College of Physicians and Surgeons of Canada (RCPSC), we have been following competency based medical education (CBME). Competence-by-design (CBD) promotes accountability, flexibility and learner centeredness. The focus is on ensuring each resident acquires the necessary competencies set forth by the Royal College before they progress through each of 4 stages: transition to discipline (~4months), foundations of discipline (~21 months), core of discipline (~30 months), transition to practice (~6 months).
Entrustable professional activities (EPAs) are everyday tasks we perform as physicians that the Royal College has identified as key tasks of the discipline. EPAs are designed to be developmental and progress from basic tasks to complex tasks as trainees move through the stages of training. Faculty will complete EPA forms for each resident, offering the opportunity for direct observation and feedback during rotations. Residents are expected to keep track of these EPAs.  Within each EPA are a number of milestones. These are individual skills needed to accomplish the EPA. You will recognize the language around milestones, as it is derived from the CanMEDS framework (e.g. medical expert, communicator, collaborator, leader, etc.).   A comprehensive list of EPAs can be found at the end of this document.