Geriatrics Entrustable Professional Activities

Geriatricians entering into unsupervised practice, in and across all care settings, are able to:

1. 1. Provide patient centered care that optimizes function and/or well‐being.  
2. 2. Prioritize and manage the care of older patients by integrating the patient's goals and values, co‐ morbidities and prognosis into the practice of evidence‐based medicine.  
3. 3. Assist patients and families in clarifying goals of care and making care decisions.
4. 4. Prevent, diagnose and manage geriatric syndromes.  
5. 5.  Provide comprehensive medication review to maximize benefit and minimize number of medications and adverse events.
6. 6.  Provide palliative and end‐of ‐life care for older adults.
7. 7. Coordinate healthcare and healthcare transitions for older adults with multimorbidity and multiple providers.
8. 8. Provide geriatric consultation and co‐management.
9. 9. Skillfully facilitate a family meeting.
10. 10. Collaborate and work effectively as a leader or member of an interprofessional health care team.  
11. 11. Teach the principles of geriatric care and aging‐related health care issues to professionals, patients, families, health care providers and others in the community.
12. 12. Collaborate and work effectively in quality improvement and other systems‐based initiatives to assure patient safety and improve outcomes for older adults.

AGS/ADGAP Geriatric Fellowship Curricular Milestones and Entrustable Professional Activities

The culmination of a significant body of work, AGS and the Association of Directors of Geriatric Academic Programs (ADGAP) have released Curricular Milestones for Graduating Geriatric Fellows and End-of-Training Entrustable Professional Activities (EPAs) for Geriatric Medicine. Both documents, recently published in the Journal of the American Geriatrics Society, were created to support academic geriatric programs and geriatric fellowship program directors in developing curricula and assessments that address the Accreditation Council for Graduate Medical Education Next Accreditation System, which begins in July 2014.

In December 2012, 76 curricular milestones, developed by an AGS/ADGAP workgroup and approved by the Boards of both organizations, were first posted on the Portal of Geriatric Online Education (POGOe). The milestones were established to determine what every graduating geriatric fellow should be able to demonstrate to ensure they will be able to practice effectively and safely in all care settings and with different older adult populations. The new JAGS article,Curricular Milestones for Graduating Geriatric Fellows, presents the milestones and the process used to develop them.

What is a Geriatrician, describes the collaborative process behind the development of 12 end-of-training EPAs for geriatric medicine. EPAs describe the core work that constitutes a discipline’s specific expertise. They are critical, observable, measurable tasks and responsibilities that practicing specialists can be trusted to perform proficiently, consistently, and unsupervised by the end of their training. Developed by a workgroup of AGS and ADGAP members, the EPAs emphasize the complexity of geriatrics care—and that geriatrics is truly an individualized approach to medicine that recognizes good quality of life as one of the most important outcomes for patients.

Our thanks to all AGS and ADGAP members, and others involved in this important work, which advances competency-based geriatrics fellowship training and addresses the newest developments in medical education and accreditation.

Serious Illness Communication Evaluation Tool (SICET)

Serious Illness Communication Evaluation Tool (SICET)

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