Students collect evidence for each domain, in the form of either an EPA (a component of the clinical encounter such as histories etc), Clinical Skills or Clinical Examination forms. These are typically completed on the student’s phone, and can be signed of in-person or via email, with students populating a portfolio throughout the clinical years of the programme.

For each EPA, supervisors judge how much they can trust students to carry out that activity safely and effectively.

The EPAs are:

• EPA 1 - Undifferentiated assessment - Take a focused history and perform an appropriate examination of an undifferentiated patient, formulating an initial prioritised problem list.

• EPA 2 - Assessment of acutely unwell patients - Recognise and assess the deteriorating patient and initiate immediate management and escalation.

• EPA 3 - Diagnostic planning - Formulate and justify an appropriate differential diagnosis and plan further investigations and tests.

• EPA 4 - Management planning - Develop a safe, effective and patient-centred management plan, including monitoring and follow up.

• EPA 5 - Safe prescribing - Demonstrate good knowledge of medicines and prescribing; select appropriate medicines, understand doses and routes, complete medicines reconciliation, recognise adverse effects and monitor response and safety.

• EPA 6 - Managing multimorbidity - Assess and manage patients with multiple long-term conditions, prioritising care and shared decision making.

• EPA 7 - Managing complexity and uncertainty - Apply clinical reasoning to complex and uncertain situations, making appropriate decisions with limited information.

• EPA 8 - Communication with patients - Communicate clearly, sensitively and effectively with patients and carers, sharing information and involving them in care.

• EPA 9 - Documentation and transitions of care - Document clinical information accurately and communicate effectively during handoffs and transitions in care.

• EPA 10 - Working in a team - Work effectively as a valued member of the clinical team and collaborate with others to deliver safe, high quality care.

• EPA 11 - Professionalism and patient safety - Demonstrate professional behaviour, integrity and respect, and recognise and act to maintain patient safety.

• EPA 12 - Goals of care and escalation - Recognise when goals of care need to be discussed or reviewed and escalate appropriately.