Entrustable Professional Activities (EPAs)

CBD Logo

EPA 101 Psychiatry

In CBD, Entrustable Professional Activities (EPAs) are defined by the Royal College as “authentic tasks of a discipline. A supervisor can delegate a task to a resident and observe their performance in the workplace. Over time, frequent observations of a trainee’s performance of an EPA, will provide a comprehensive image of their competence and inform promotion decisions.” EPA example: Develop and implement a management plan in a patient with a common mental health concern.

EPAs are related to each stage of training (see competency stage graphic here). EPAs are designed to be developmental — they go from smaller tasks to bigger tasks as trainees progress through stages of training. Each EPA integrates a number of milestones from different CanMEDS roles; a bigger task may include more milestones and/or more complex milestones.

The Department of Psychiatry has developed 18 EPAs thus far. Two are applicable to the Transition to Discipline stage of competency (first 1 - 3 months), seven are applicable to the Foundations of Discipline stage of competency which extends from the end of Transition to Discipline through to the end of PGY2 (e.g. the resident's first 24 months of training), and 9 are applicable to the Core of Discipline stage of competency (essentially PGY3 and PGY4).

An overview of the existing EPAs is available here: EPAs Overview. Detailed information regarding specific EPAs can be found in the Current EPAs section.

Current EPAs (2019-2020)

Details of each Entrustable Professional Activity (EPA) are included in the EPA specific information sheets here:

Transition to Discipline #1 - Basic History

Transition to Discipline #2 - Documentation & Orders

Foundations of Discipline #1 - Common Assessment

Foundations of Discipline #2 - Common Formulation & Plan

Foundations of Discipline #3 - Risk Assessment

Foundations of Discipline #4 - Legislation

Foundations of Discipline #5 - Medical Stability

Foundations of Discipline #6 - Critical Appraisal

Core of Discipline #1 - Complex Assessment

Core of Discipline #2 - Complex Formulation

Core of Discipline #3 - Complex Plan

Core of Discipline #4 - Medical Emergency

Core of Discipline #5 - Family Meeting

Core of Discipline #6 - Agitation & Aggression

Core of Discipline #7 - Neurostimulation

Core of Discipline #8 - Psychopharmacology

Core of Discipline #9 - Teaching

Core of Discipline #10 - Psychotherapy Modalities

How are EPAs Assessed?

We are currently using PsychRocks as our EPA Tool. As of July 2020, our program will be utilizing Elentra. Stay tuned for faculty development opportunities!

EPA Observations and Achievement

EPAs (after July 1 2020)

All Psychiatry training programs will be adopting the Royal College of Physicians and Surgeon's Entrustable Professional Activities as of July 2020.  The EPAs are available for download and viewing below. 

Transition to Discipline

TTD1 OBTAINING A PSYCHIATRIC HISTORY to inform the preliminary diagnostic impression

TTD2 COMMUNICATING CLINICAL ENCOUNTERS in oral and written/electronic form

Foundations of Discipline

FOD1 Assessing, diagnosing and participating in the management of patients with MEDICAL PRESENTATIONS relevant to psychiatry

FOD2 PERFORMING PSYCHIATRIC ASSESSMENTS referencing a biopsychosocial approach, and developing basic differential diagnoses for patients with mental disorders

FOD3 Developing and implementing MANAGEMENT PLANS for patients with presentations of low to medium complexity

FOD4 Performing RISK ASSESSMENTS that inform the development of an acute safety plan for patients posing risk for harm to self or others

FOD5 Performing CRITICAL APPRAISAL and presenting psychiatric literature


Core of Discipline

COD1 Developing COMPREHENSIVE treatment/management PLANS for adult patients

COD2 Performing psychiatric assessments and providing differential diagnoses and management plans for CHILDREN AND YOUTH

COD3 Performing psychiatric assessments, and providing differential diagnoses and management plans for OLDER ADULTS

COD4 Developing comprehensive biopsychosocial FORMULATIONS for patients across the lifespan

COD5 Identifying, assessing, and managing emergent situations in psychiatric care across the lifespan (EMERGENCIES)

COD6a Integrating the principles and skills of psychotherapy into patient care (PSYCHOTHERAPY MODALITY)

COD6b Applying and integrating psychosocial skills and principles in general psychiatric care (INTEGRATING PSYCHOTHERAPY SKILLS)

COD7 Integrating the principles and skills of NEUROSTIMULATION into patient care

COD8 Integrating the principles and skills of PSYCHOPHARMACOLOGY into patient care

COD9 Applying relevant legislation and LEGAL principles to patient care and clinical practice

COD10 Providing TEACHING to students, residents, public and other health care professionals

Transition to Practice

TTP1a Managing the clinical and administrative aspects of a psychiatric practice: patient care (PRACTICE MANAGEMENT)

TTP1b Managing the clinical and administrative aspects of a psychiatric practice: working with the team (PRACTICE MANAGEMENT)

TTP2 SUPERVISING junior trainees

TTP3a Developing and implementing personalized learning experiences geared to career plans or future practice: Developing a Learning Plan (PERSONALIZED LEARNING PLAN)

TTP3b Developing and implementing personalized learning experiences geared to career plans or future practice: Implementing a training experience (PERSONALIZED LEARNING PLAN)

TTP3c Developing and implementing personalized learning experiences geared to career plans or future practice: Reflecting on learning plan efficacy (PERSONALIZED LEARNING PLAN)