Entrustable professional activities (EPAs), or "everyday pediatrician activities," are observable, routine activities that a pediatric subspecialist should be able to perform safely and effectively to meet the needs of their patients. The ABP has worked with the pediatrics community to develop an EPA framework for general pediatrics and all of the subspecialties. Seven EPAs are common to all subspecialties, and each subspecialty has three or more additional EPAs that are unique to the subspecialty. This EPA framework can be used for both assessment and curricular development across the entire education continuum and can be found below.
More information on EPAs in pediatrics can be found in this quick, four-minute video: EPAs 101: What is an Entrustable Professional Activity.
EPAs That are Common to all Subspecialties
Individual EPAs, with their corresponding curricular components, are below.
EPA: Contribute to the fiscally sound, equitable, and collaborative management of a health care workplace
Curricular components supporting the functions of the EPA
EPA: Use Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations
Curricular components supporting the functions of the EPA
EPA: Lead an interprofessional health care team
Curricular components supporting the functions of the EPA
EPA: Facilitate handovers to another health care provider either within or across settings
Curricular components supporting the functions of the EPA
EPA: Engage in scholarly activities through the discovery, application, and dissemination of new knowledge (broadly defined)
Curricular components supporting the functions of the EPA
EPA: Lead within the subspecialty profession
Curricular components supporting the functions of the EPA
Subspecialty-Specific EPAs
Adolescent Medicine
Provide care for adolescent and young adult patients with acute physical and mental health issues |
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Provide continuity of care for adolescent and young adult patients with chronic medical problems and complex health conditions |
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Provide preventive health care that includes the conditions specific to the adolescent and young adult population |
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Transition care of the adolescent and young adult patient to adult health care settings |
Cardiology
Acquire the imaging skills required for all aspects of pediatric and cardiology care |
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Care for patients who require catheter-based interventions |
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Diagnosis and management of patients with arrhythmias and conduction abnormalities |
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Diagnose, initially manage, and refer children with advanced or end stage heart failure and/or pulmonary hypertension to experts for medical therapy, ECMO, ventricular assist devices, and/or cardiac transplantation |
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Diagnosis and management of patients with congenital or acquired cardiac problems |
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Diagnosis and management of patients with acute congenital or acquired cardiac problems requiring intensive care |
Child Abuse Pediatrics
Provide subspecialty medical evaluation for children and adolescents who are suspected victims of sexual abuse or assault |
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Engage in behaviors and use coping strategies that will mitigate the emotional stress of caring for patients that have been abused, neglected, or maltreated |
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Provide subspecialty medical evaluation in cases of suspected child neglect and other forms of child maltreatment |
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Provide Subspecialty Medical Evaluation in Cases of Suspected Child Physical Abuse |
Critical Care Medicine
Acute management of the critically ill patient, including those with underlying chronic disease |
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Manage and coordinate care in pediatric critical care units for optimal patient outcomes |
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Management of patients at the end of life |
Developmental-Behavioral Pediatrics
Effectively advocate for children and families affected by developmental and behavioral disorders |
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Effectively communicate with families, schools, and community organizations to facilitate their understanding of children’s developmental-behavioral diagnoses and to promote their engagement in clinical decision-making and treatment |
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Perform comprehensive histories and physical and neurodevelopmental examinations to make accurate diagnoses for patients presenting with developmental-behavioral concerns from infancy through young adulthood |
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Recognize and longitudinally manage behavioral variations, problems, and disorders in typically developing children and children with developmental disorders |
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Recommend appropriate medical workup and evidence-based medical, therapeutic, educational, and behavioral interventions for children with developmental-behavioral disorders |
Emergency Medicine
Recognize and provide care for acutely ill and/or injured pediatric patients presenting to the Emergency Department (ED) |
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Recognize and provide care for medically and technologically complex pediatric patients in the ED |
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Demonstrate competence in performing common procedures associated with the practice of pediatric emergency medicine |
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Provide patient triage, resuscitation, and stabilization; align care provided with severity of illness |
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Emergency Department Management: Manage the emergency department to optimize patient care |
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Provide supervision for emergency personnel to enhance patient care quality and assure patient safety |
Endocrinology
Know the indications for performing the common procedures of the pediatric endocrinologist and be able to interpret the results |
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Facilitate the transition of patients with endocrine disorders from pediatric to adult health care |
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Manage patients with acute endocrine disorders in ambulatory, emergency, or inpatient settings |
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Manage patients with chronic endocrine disorders in ambulatory, emergency, or inpatient settings |
Gastroenterology
Care of infants, children, and adolescents with acute and chronic gastrointestinal disorders |
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Care of infants, children, and adolescents with acute and chronic liver diseases, biliary/cholestatic diseases, pancreatic disorders, and those requiring liver transplantation |
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Care for infants, children, and adolescents with common outpatient GI, liver/biliary, pancreatic, and nutritional issues |
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Care of infants, children, and adolescents with nutritional issues, deficiencies, and obesity |
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Perform medical procedures related to gastrointestinal and liver disease for screening, diagnosis, and intervention |
Hematology-Oncology
Manage patients with hematology-oncology conditions, whether acute or chronic, simple or complex, in an ambulatory, emergency, or inpatient setting |
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Enroll and treat patients on clinical research trials |
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Provide a medical home for patients with hematologic, oncologic, or stem cell transplant needs |
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Introduce and facilitate the integration of palliative care for patients with advanced disease |
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Demonstrate competence in performing and interpreting common procedures of a pediatric hematologist/oncologist |
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Facilitate the transition of care |
Hospital Medicine
Care for acutely ill patients in hospital settings |
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Direct and coordinate care for patients with unclear diagnoses and complex patients |
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Perform common procedures associated with the practice of pediatric hospital medicine |
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Anticipate, facilitate, and lead comprehensive, coordinated, and safe transitions of care |
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Apply science of safety concepts in advocating for pediatric patients within the hospital system |
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Teach, provide feedback, and assess learners across a competency-based medical education continuum and engage in interprofessional education |
Infectious Diseases
Promoting antimicrobial stewardship based on microbiological principles |
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Management and prevention of infections associated with medical/surgical devices, surgery, and trauma |
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Management of healthy patients with pediatric infectious diseases |
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Management of pediatric patients with complex medical problems and a proven or suspected infectious disease |
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Prevention and containment of infection |
Neonatal-Perinatal Medicine
Management patients with acute, common single system diseases in an inpatient setting |
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Manage patients with complex, multisystem diseases in the NICU |
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Provide care to patients in the NICU with surgical problems in collaboration with pediatric and subspecialty surgeons |
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Provide resuscitation and stabilization of neonates and infants that aligns care with severity of illness |
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Management of neonatal care systems |
Nephrology
Care of children with acute electrolyte and kidney disorders, including hypertension and disorders of the urinary tract |
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Care of children with chronic electrolyte and kidney disorders, including hypertension and disorders of the urinary tract |
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Care of the pediatric patient with ESKD and kidney transplant |
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Provision and supervision of kidney-related procedures including native and transplant kidney biopsy, peritoneal dialysis |
Pulmonology
Manage patients with acute complex respiratory disease in an ambulatory, emergency, or inpatient setting |
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Manage patients with complex chronic respiratory disease through all settings and phases of life |
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Demonstrate competence in communicating a new diagnosis of a life-altering disease using a patient and family centered approach |
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Manage the use of supplemental respiratory equipment such as oxygen, ventilators, and airway clearance devices |
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Demonstrate competence in performing the common procedures of the pediatric pulmonary subspecialist |
Rheumatology
Demonstrate competence in the utilization of immunomodulatory therapy for pediatric rheumatology patients |
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Manage patients with acute or chronic complex multi-system rheumatic disease in an ambulatory, emergency, or inpatient setting |
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Provide or coordinate a medical home for patients with complex and chronic rheumatic disease |
Pediatric Transplant Hepatology
Care for infants, children, and adolescents who are pre-, peri-, and post-liver transplant |
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Care for infants, children, and adolescents who have been exposed to and/or are chronically infected with viral hepatitis |
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Care for infants, children, and adolescents with acute and chronic biliary/cholestatic diseases |