Lessons learned from real-world implementation of entrustable professional activities in an internal medicine residency programme

The competency-based medical education framework has driven the adoption of entrustable professional activities (EPAs) for workplace-based assessment, yet real-world implementation experience from Southeast Asian settings remains scarce. In this commentary, the authors describe the transition to an EPA-based assessment model in an internal medicine residency programme in Singapore, drawing on perspectives from the programme director, core faculty members, programme coordinator, and graduates who participated in a roundtable discussion. Six key lessons emerged. First, explicit and repeated dialogue about trust is needed to secure buy-in from learners and assessors. Second, EPA tasks and standards must be clearly linked to core professional competencies while balancing assessment burden through simplified, distributed workplace-based assessments. Third, informal feedback from supervisors, though often undocumented, carries valuable performance information that should be systematically captured. Fourth, overall