A 45-year-old eighth-grade math teacher visits your office in mid-December 2003, complaining of temperature to 38.6°C (101.5°F), dry cough, sore throat, myalgias, and malaise. Her symptoms began approximately 24 hours earlier, but she continued to teach through the end of the school day. A number of children in her classes have been absent due to similar complaints over the past 2 weeks. Her physical examination is notable for readily apparent malaise, temperature of 38.5°C (101°F), mild pharyngeal erythema with no exudates, no adenopathy, and clear lung fields. She has taken acetaminophen and ibuprofen for fever and muscle aches, with modest relief. Her medical history is notable for hypertension and gastroesophageal reflux disease, for which she takes hydrochlorthiazide and lansoprazole, respectively. Aside from 2 normal deliveries more than 10 years previously and an appendectomy during childhood, she has not been hospitalized. This year, as in prior years, she chose not to receive influenza vaccine. She comes to you suspecting that she might have "the flu" and asking whether she needs any stronger medication to help her return to the classroom more quickly.

Physician reimbursements, even with 100% billing and collections, are inadequate to support the activities of most clinics providing HIV care. These findings have important implications for the continued support of HIV treatment programs in the United States.

Currently, no standard defines the clinical skills that medical students must demonstrate upon graduation. The Liaison Committee on Medical Education bases its standards on required subject matter and student experiences rather than on observable educational outcomes. The absence of such established outcomes for MD graduates contributes to the gap between program directors' expectations and new residents' performance.In response, in 2013, the Association of American Medical Colleges convened a panel of experts from undergraduate and graduate medical education to define the professional activities that every resident should be able to do without direct supervision on day one of residency, regardless of specialty. Using a conceptual framework of entrustable professional activities (EPAs), this Drafting Panel reviewed the literature and sought input from the health professions education community. The result of this process was the publication of 13 core EPAs for entering residency in 2014. Each EPA includes a description, a list of key functions, links to critical competencies and milestones, and narrative descriptions of expected behaviors and clinical vignettes for both novice learners and learners ready for entrustment.The medical education community has already begun to develop the curricula, assessment tools, faculty development resources, and pathways to entrustment for each of the 13 EPAs. Adoption of these core EPAs could significantly narrow the gap between program directors' expectations and new residents' performance, enhancing patient safety and increasing residents', educators', and patients' confidence in the care these learners provide in the first months of their residency training.