Benjamin L Cohen ^1 2, Zane R Gallinger ^1 3, Christina Ha ⁴, Stefan D Holubar ⁵, Jason K Hou ⁶, Jami Kinnucan ⁷, Uma Mahadevan ⁸, Alan C Moss ⁹, Laura E Raffals ¹⁰, Miguel Regueiro ², Eva Szigethy ^11 12, Douglas Wolf ¹³, Marla C Dubinsky ¹⁴, Anish Patel ^1 15, Brijen J Shah ¹, Orna G Ehrlich ¹⁶, Stephen B Hanauer ¹⁷

Author information

• ¹Dr Henry D Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA.
• ²Department of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
• ³Division of Gastroenterology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
• ⁴Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
• ⁵Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
• ⁶Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
• ⁷University of Michigan, Ann Arbor, MI, USA.
• ⁸Division of Gastroenterology, University of California, San Francisco, CA, USA.
• ⁹Department of Medicine and Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
• ¹⁰Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
• ¹¹Department of Gastroenterology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
• ¹²Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
• ¹³Atlanta Gastroenterology Associates, Atlanta, GA, USA.
• ¹⁴Department of Pediatrics, Mount Sinai Hospital and Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center, New York, NY, USA.
• ¹⁵Division of Gastroenterology, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
• ¹⁶Crohn's & Colitis Foundation, New York, NY, USA.
• ¹⁷Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Abstract

Background: The level of inflammatory bowel disease (IBD) training in general gastroenterology fellowship is often insufficient to prepare trainees to deliver advanced IBD care in practice. Advanced IBD fellowships have been developed to fill this training gap, but there is no established curriculum, and significant variability exists across programs. Entrustable professional activities (EPAs) are practical and realistic objectives that define essential tasks of a specialty that physicians should master to be competent during independent practice. The American College of Gastroenterology (ACG) and Crohn's & Colitis Foundation (Foundation) established a task force to develop and appraise EPAs for advanced IBD fellowship.

Methods: Entrustable professional activities were developed using a multistep approach in a similar manner to other specialties. Initial EPAs identified via focus groups were evaluated, critiqued, and changed using an iterative model of feedback. The final EPAs were selected after the task force conducted a 3-phase modified Delphi method consisting of 2 sequential rounds of web-based voting and an in-person consensus meeting.

Results: Ten EPAs for advanced IBD fellowship were established including detailed descriptions with the associated knowledge, skills, and attitudes for each that can serve as curricular milestones.

Conclusion: Ten EPAs describing the core work of an advanced IBD fellowship-trained physician have been established by a multisociety task force. Creating EPAs for an advanced curriculum comes with unique challenges, particularly the need to prevent duplication of prior training competencies while demonstrating the potential for unique milestones.