Establishing an Entrustable Professional Activity-Based Curriculum for Postgraduate Respiratory Medicine Training: A National Consensus Process

INTRODUCTION: Postgraduate training in adult respiratory medicine in Switzerland has traditionally relied on fixed training times and procedural numbers. In line with competency-based medical education (CBME), the Swiss Society of Pneumology (SGP/SSP) initiated the development of an entrustable professional activity (EPA)-based curriculum to better align training with clinical practice and outcomes. METHODS: In 2023, the SGP Postgraduate Training Commission formed a multidisciplinary working group representing all Swiss linguistic regions and training centre types. Through a structured consensus process - including literature review, iterative consensus meetings using a modified Delphi process, and coaching by the Swiss Institute for Medical Education (SIME/SIWF/ISFM) - a national EPA list was created. All EPAs have been elaborated using the EQual rubric as a quality standard. Final approval was granted by the SGP and SIME in 2025. DISCUSSION: The novel EPA-based curriculum represents a shift from time- and number-based requirements to competency-oriented postgraduate education in adult respiratory medicine. We describe the development process, conceptual framework, and key lessons learnt. By integrating programmatic assessment and EPAs with frequent workplace-based assessments, it aims to enhance feedback culture, entrustment decisions, and individualized learning, providing a model for other national training programs and specialties adopting CBME.