Retirement of the external long case and introduction of entrustable professional activities (EPAs)

The decision follows a comprehensive review undertaken by a working group comprising members of the Examinations Committee, Learning and Development Committee and trainee representatives.

The review concluded that while the long case remains an educationally valuable learning activity, the capabilities assessed through the long case are more effectively assessed through workplace-based evidence gathered over time as a formative, workplace-based activity embedded within entrustable professional activities (EPAs), rather than as a standalone progression gate.

At the July board meeting, the decision was made to transition away from the current model through:

• The retirement of the external long case at the conclusion of 2026.
• The integration of the capabilities currently assessed through the long case into the EPA framework commencing from 2027.

Trainees seeking progression to fellowship in 2026 will still be required to successfully complete the external long case assessment under the current training program requirements. 

Introduction of entrustable professional activities (EPAs)

EPAs are a workplace-based approach to assessment. They set out the professional activities pain medicine trainees must be trusted to perform, the evidence used to support supervision decisions, and how feedback supports progression through training. 

Rather than capturing a snapshot of performance in a single assessment, EPAs build a longitudinal picture of your capability across multiple clinical encounters and settings.

The following EPAs will be introduced into the training program:

EPA implementation will be phased. Additional information, including guidance materials, assessment requirements and implementation dates, will be communicated before individual EPAs become progression requirements.

Transition arrangements

With EPAs scheduled for implementation from the start of the 2027 training year, the FPM board has approved transition arrangements for trainees currently enrolled in the program. These arrangements are designed to recognise training and assessment already completed, minimise disruption and support equitable progression during the transition period.

Further information about EPAs will be published on the FPM website shortly. 

Trainees due to complete the Core Training Stage (CTS) by the commencement of the 2027 hospital employment year (HEY)

• Trainees who have completed, or are due to complete the CTS by 1 February 2027, will be credited with EPA 1 (assessment) and EPA 3 (formulation). 
• These trainees will be required to complete EPA 2 (pharmacology), EPA4 (management plan) and EPA 5 (leading multidisciplinary teams) during their Practice Development Stage (PDS).

Trainees who will still be undertaking the CTS at the commencement of the 2027 HEY

• Trainees who haven’t completed their CTS by 1 February 2027 will be required to complete EPAs 1-3 (assessment, pharmacology and formulation) prior to being eligible for the PDS year, except:

• Trainees who have passed a long case assessment (either internal or external) by 1 February 2027, will be exempt from EPA 1 (assessment) and EPA 3 (formulation).
• For trainees who have not passed a long case assessment, their workplace-based feedback (WBF) record will be reviewed and transition requirements determined.

• Trainees due to complete the PDS year in 2027 need to complete EPA 2 (pharmacology), EPA 4 (management plans) and EPA 5 (leading multidisciplinary teams) before progression to fellowship.
• For trainees who have not passed a long case assessment, their workplace-based feedback (WBF) record will be reviewed and transition requirements determined.

Trainees undertaking a trainee support or performance review process

Trainees undertaking a trainee support process or trainee performance review on 1 February 2027 will be provided with individualised arrangements aligned to their remediation plan.

Trainees who have completed their training time by 1 February 2027

• Trainees who only have the scholar role activity or Fellowship Examination outstanding will be exempt from completing EPAs. 
• For trainees who have not passed an internal long case assessment, individualised arrangements will be developed. 

Questions relating to the transition arrangements should be directed to the FPM team.

Supporting implementation

To support implementation of EPAs, the supervisor of training (SOT) workshop at the Spring Meeting will focus on the practical application of EPAs within the workplace setting. Recognising that not all supervisors will be able to attend in person, a series of virtual workshops will also be delivered in the coming months to ensure broad engagement and readiness across accredited training settings.