Measuring competency is a challenge all training programs must address to ensure that their residents can practice independently after graduation. Over the course of training, achievement of competence should be measured to ensure that residents can perform specific actions independently, so called entrustable professional activities (EPA). These activities are complex and heterogeneous, involving the application of knowledge as well as the performance of specific psychomotor skills. In addition to the 6 core competencies established by Accreditation Council for Graduate Medical Education (ACGME), many specialties now have established milestones in training to track the development of specific competencies over the course of training. These milestones describe discrete observable behaviors that correlate with different levels of performance from novice to expert.
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