Introducing entrustable professional activities for postgraduate medical training in Switzerland

Graduate medical education is being reformed in many countries, with a focus on the principles of competency-based medical education (CBME). A main novel aspect in this context is the implementation of entrustable professional activities (EPAs). The introduction of EPAs aims to better align training curricula with clinical practice, provide individualized supervision, and enhance the quality of feedback.

This project report presents the development of a national strategy and the initial results of implementing entrustable professional activities in the Swiss context.

Affiliated with the Swiss Institute of Medical Education (SIME), an EPA-Commission was established with the mandate to develop a strategy and provide guidance to medical specialty societies. To date, 28 out of 45 specialty societies have sought advice from the EPA-Commission and have begun developing EPAs. Concurrently, the Commission has expanded the national faculty development courses, adapted the content, started offering multilingual courses, and has published a series of articles on CBME and EPAs. Selected pilot hospitals are now planning to implement EPA-based graduate medical education curricula. Additionally, the introduction of a nationwide electronic solution (app) for assessing EPAs is planned.

The introduction of EPAs in graduate medical education is a multilayered project. In addition to medical education aspects, various social, organizational, and professional-political factors are crucial for the transformation processes. In the Swiss context, such a reform has been successfully initiated. Continuous evaluations of the ongoing projects will provide further insights for competency-based graduate medical education reforms.