Table 1 EPAs resulted in studies on internal medicine residency programs adapted from O’dawed et al. [51]

Caverzagie et al.,

201 5[47].

USA

1. Manage care of patients with acute common diseases across multiple care settings.

2. Manage care of patients with acute complex diseases across multiple care settings.

3. Manage care of patients with chronic diseases across multiple care settings.

4. Provide age-appropriate screening and preventative care.

5. Resuscitate, stabilize, and care for unstable or critically ill patients.

6. Provide perioperative assessment and care.

7. Provide general internal medicine consultation to nonmedical specialties.

8. Manage transitions of care.

9. Facilitate family meetings.

10. Lead and work within interprofessional health care teams.

11. Facilitate the learning of patients, families, and members of the interdisciplinary team.

12. Enhance patient safety.

13. Improve the quality of health care at both the individual and systems level.

14. Advocate for individual patients.

15. Demonstrate personal habits of lifelong learning.

16. Demonstrate professional behavior.

Hauer, Kohlwes, Cornett et al.,

2013 [48]

USA

1. Evaluate and manage a new problem in a continuity ambulatory patient requiring coordination of care between providers and across settings.

2. Admit and manage a medical inpatient with a new acute problem on a medical floor.

3. Admit and manage a medical inpatient with an acute exacerbation of a chronic problem on a medical floor.

4. Lead a family meeting to discuss serious or sensitive news with patient and/or family and other health providers.

5. Perform initial H&P, develop problem list, and plan for new ambulatory patient in continuity practice.

6. Provide continuity care, conducting interval visits, for primary care patients with multiple chronic conditions.

7. Develop and implement a safe discharge plan for a patient from the acute care setting.

8. Discuss serious news with a patient and/or family (bad news, end-of-life care planning).

9. Provide continuity care, conducting interval visits, for primary care patients.

10. Triage medically ill patients to an appropriate level of care.

11. Access medical information to provide evidence-based care for adult patients.

12. Identify and manage acute, emergent problems.

13. Provide urgent and emergent cross-coverage care to medicine inpatients.

14. Lead a team in managing multiple inpatients.

15. Recognize and diagnose common non-internal medicine (surgical, neurological, dermatologic, etc) problems and appropriately refer to subspecialty care.

16. Diagnose conditions for and co-manage patients with complex problems needing subspecialty care (inpatient or outpatient).

17. Manage information and knowledge for personal learning to improve care delivery and to educate others (journal club, etc.)

18. Institute palliative care appropriately in collaboration with palliative care specialists.

19. Perform behavioral counselling with a patient.

20. Provide medical consultation for patients receiving nonmedical services.

21. Admit and manage a medical ICU patient.

22. Identify and address a quality improvement need in a clinical setting.

23. Provide telephone management of an acute problem for an ambulatory patient.

24. Provide care to an inpatient or outpatient non-English speaking patient, using appropriate translator services.

25. Develop and implement an action plan based on review of performance data for one’s ambulatory patient panel.

26. Provide inpatient and outpatient care for patients with challenges in access to care that inappropriately address those challenges.

27. Conduct or participate in a scholarly project (research, QI, education, other).

28. Participate and believe an inpatient cardiopulmonary resuscitation.

29. Provide initial management and contribute to postoperative care for patients presenting with surgical problems.

30. Perform common procedures in internal medicine (LP, thoracentesis, central line, arthrocentesis).

Pugh et al., 2017 [49]

Canada

1. Central venous catheter insertion.

2. Lumbar puncture.

3. Peripheral arterial catheter insertion.

4. Paracentesis.

5. Endotracheal intubation.

6. Thoracentesis.

7. Knee arthrocentesis.

Taylor et al., 2018 [50]

Canada

Transition to Discipline

1. Performing histories and physical examinations and documenting and presenting findings across clinical settings for initial and subsequent care.

2. Identifying and assessing unstable patients, providing initial management, and obtaining help.

3. Performing the basic procedures of internal medicine

Foundations of discipline

4. Assessing, diagnosing, and providing initial management for patients with common acute medical presentations in acute care settings.

5. Managing patients admitted to acute care settings with common medical problems and advancing their care plans.

6. Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan.

7. Formulating, communicating, and implementing discharge plans for patients with common medical conditions from acute care settings.

8. Assessing unstable patients and providing targeted treatment and consulting as needed.

9. Discussing and establishing patients’ goals of care.

10. Identifying personal learning needs while caring for patients and addressing those needs.

Core of Discipline

11. Assessing, diagnosing, and managing patients with complex or atypical acute medical presentations.

12. Assessing and managing patients with complex chronic conditions.

13. Providing internal medicine consultation to other clinical services.

14. Assessing, resuscitating and managing unstable and critically ill patients.

15. Performing the procedures of internal medicine.

16. Assessing capacity for medical decision making.

17. Discussing serious and/or complex aspects of care with patients, families, and caregivers.

18. Caring for patients who have experienced a patient safety incident (adverse event).

19. Caring for patients at the end of life.

20. Implementing health promotion strategies in patients with or at risk for disease.

21. Supervising junior learners in the clinical setting.

Transition to practice

22. Managing an inpatient medical service.

23. Managing longitudinal aspects of care in a medical clinic.

24. Assessing and managing patients with uncertain diagnosis and/or treatment.

25. Providing consultations to off-site healthcare providers.

26. Initiating and facilitating transfers of care through the health care system.

27. Working with other physicians and healthcare professionals to develop collaborative patient care plans.

28. Identifying learning needs in clinical practice and addressing them with a personal learning plan.

29. Identifying and analyzing system level safety, quality, or resource stewardship concern in health care delivery.