Entrustable Professional Activities - General Surgery

• The ABS EPA Project first began with general surgery and is now in development for the other ABS specialties. As such, EPAs will be launching in July 2023 for general surgery residency programs, with the other ABS specialties to follow in the coming years.

The General Surgery EPAs

• The ABS has been hard at work since the conclusion of the pilot in 2020, and presents the final list of 18 core EPAs below. Each EPA has a full description and includes the associated functions and behaviors that will be evaluated for general surgery:

1. RLQ pain/Appendicitis *
2. Benign or malignant breast disease
3. Benign or malignant colon disease
4. Gallbladder disease *
5. Inguinal hernia *
6. Abdominal wall hernia
7. Acute abdomen
8. Benign anorectal disease
9. Small bowel obstruction
10. Thyroid and parathyroid disease
11. Dialysis access
12. Soft tissue infection
13. Cutaneous and subcutaneous neoplasms
14. Severe acute or necrotizing pancreatitis
15. Perioperative care of the critically ill surgery patient
16. Flexible GI Endoscopy
17. Evaluation/initial management of a trauma patient *
18. Provide general surgery consultation *

* Initial EPA evaluated during 2018-2020 EPA Pilot

You can access a combined document that includes all 18 EPAs here.

ABS General Surgery EPA Task Forces and Working Groups

• There have been two councils and five working groups responsible for the development and implementation of the ABS EPA initiative: the EPA Advisory Council; the EPA Scope Council; the EPA Revision Working Group; the EPA Best Practices Working Group; the EPA Technology Task Force; the EPA Writing Group; and the EPA Development Task Force. All five working groups include resident members who provide valuable insight and recommendations from the trainees' perspective.
• For a list of volunteers who have been involved with these task forces and working groups, please see here.
• The following five groups are currently actively involved in the development and implementation of EPAs in all U.S.-based general surgery residency programs:

EPA Advisory Council

• The EPA Advisory Council oversees the entire EPA project and provides much-needed expertise about surgical education and EPAs. This group is comprised of members and representatives from many of our partnering organizations, including a number of program directors from varying program types who were part of the 2018-2020 ABS EPA Pilot.

EPA Scope Council

• The EPA Scope Council used insights gleaned from the pilot, alongside existing definitions of general surgery and case log data for both trainees and surgeons in practice, to define the final set of general surgery EPAs. The final suite of 18 EPAs for general surgery (listed above) has been developed by this group.
• Having completed their initial responsibilities, the group now functions as a reactor panel for the full suite of EPAs that are being written by the EPA Writing Group. The full suite of 18 general surgery EPAs is meant to define the 'floor' of the discipline, as able to be meaningfully assessed across all program types and as framed by current training requirements, practice data, and demographic need.

EPA Best Practices Working Group

• The EPA Best Practices Working Group is responsible for gathering and assessing input from pilot sites as a foundation for "best practice" strategies that will be used in EPA implementation. This group will collaborate with the EPA Development Task Force and the Education and Training Committee of the ABS Council to inform the initial EPA training tools for program directors, administrators, faculty, and trainees.

EPA Writing Group

• The EPA Writing Group is responsible for the detailed composition of the 13 additional EPAs that supplement the 5 included in the pilot to create a full suite for the discipline, including descriptions, essential functions, scope and expected behaviors. This group works in dyads with trained facilitators, each writing up to two EPAs which are then reviewed and critiqued by several reactor panel groups and ultimately will be approved through ABS Council committee structures and the General Surgery Board. Membership of this group is broad, and includes members of the various ABS specialty boards, APDS representatives, and residents.

EPA Development Task Force

• The EPA Development Task Force is comprised of educators, program directors, residency administrators, and residents, and is developing the actual materials and strategies which will equip programs, faculty, and residents in implementation of the EPAs across the full spectrum of program types. The materials being developed will be provided for programs based on insights gained from the EPA Best Practices Working Group.

The following two groups have completed their designated responsibilities and are no longer actively involved in the ABS EPA Project:

EPA Revision Working Group

• The EPA Revision Working Group was responsible for the revision of the initial five general surgery EPAs that were evaluated during the 2018-2020 pilot to make them Milestones 2.0 compliant. This group was also responsible for the development of the final entrustment scale, which will be used across all specialty EPA programs.

EPA Technology Task Force

• The EPA Technology Task Force established a list of the essential features of the electronic tools required to implement EPAs in surgical residencies and was responsible for sourcing or developing the application that would be used to track EPAs in all U.S.-based general surgery residency programs.
• Following a thorough review process, the ABS announced in September 2022 that it had selected the SIMPL Collaborative to provide the mobile platform for the ABS EPA Project. The ABS will provide this tool free of charge to all training programs for their use, with priorities around ease and efficiency of use, secure data management, and meaningful dashboard and other outputs to assist learners, programs, and accrediting agencies in their critical work.
• The same tool will be provided for the assessment of EPAs for the other ABS surgical specialties when they are introduced in the coming years.

Additional Information

This page will be updated with additional information as it becomes available.

For a collection of publications related to the ABS EPA project, please see here.

For a list of volunteers who have been involved in the general surgery arm of the ABS EPA Project, please see here.

If you have any questions about the ABS EPA Project, or have interest in getting involved, please contact our EPA project manager.