The AOA Core Competencies, described in detail in AACOM’s Osteopathic Core Competencies publication, are the domains of osteopathic physician development. These are the areas that the AOA expects students going into residency to have some degree of mastery in and they guide the development of the medical students’ curriculum. The 7 Core competencies are also TUCOM’s program learning outcomes.

Competency Based Medical Education (CBME)  has been the foundation of both undergraduate and graduate medical education for many years. It makes up the common language of undergraduate medical educators and residency program directors. The residency director wants to know if the medical student has achieved a level of competence that will allow him or her to succeed in internship.

The seven core competencies of osteopathic medical education are described in detail in the AACOM’s publication, Core Competencies for Medical Students and summarized as:

  • Osteopathic Principles and Practices
  • Medical Knowledge
  • Patient Care
  • Interpersonal and Communication Skills
  • Professionalism
  • Practice-Based Learning and Improvement
  • Systems-Based Practice

The Core Competency domains are one of two key tools to guide students’ self-assessment of residency readiness and choice of Clinical Distinction track.  The Core Competencies also guide the development of the Clinical Distinction Specialty track including the contract of learning and narrative evaluation form.

Whether a student chooses a clerkship, generalist, board success or specialty track, they will be focused on gaining expertise in 1-4 self-selected Core Competencies.  Here are a few examples:

  • A student wanting to do a clinical rotation may decide to focus their efforts during the rotation on Interpersonal and Communication Skills.
  • A student focused on the global disparities in health outcomes might complete a research project in Mexico, and demonstrate growth in the competency of Systems-Based Practice.

In selecting Core Competencies it’s important to dive into what each one means, as the list on this page is just a short hand that does not give the depth or detail of learning expected in each Core Competency. To adequately select Core Competencies download the document and review those that you are considering.

The Core Competencies are also discussed further in the section on designing your specialty track.

Why Competencies and EPAs are part of the language of Clinical Distinction

When traveling to a foreign land, learning the language first allows a more robust experience of the culture, environment and people. Relationships can develop through shared communication. EPAs and competencies are the language of medical education. They inform how educators at both the UME and GME levels communicate. It colors the landscape and influences curriculum and assessment. It is the language residency directors speak and if offers a framework for understanding the developmental process of becoming a medical professional.

Clinical Distinction offers medical students an opportunity to learn and speak the native language of their educators. The more robust the students’ use of this paradigm, the more effective their Clinical Distinction process will be. This effect will be apparent in the student experience, in the MSPE, and in the project outcome.

More Information

  • This is a key step in selecting your track and designing your project. This is a great topic of conversation to have with your CD advisor.
  • The following video is a great introduction to Competencies, EPAs and understanding how to use them in your contract.


  • More information about use of competencies in designing your specialty track project can be found on the page “Competency Selection and EPAs