「以勝任能力為導向的醫學教育」重視勝任行為的表現，訓練學習者獨立提供安全且有效率的醫療照護。課程設計者與執行者以此規劃執行學程，並以此作為學習評估與評量的依據。「里程碑」與「可信賴專業活動」是目前最常用來落實以勝任能力為導向之醫學教育的評量方法：里程碑強調醫師的勝任能力發展，提供各階段能力的具體描述；而可信賴專業活動則分析執行各種臨床專業活動所需的能力，提供執行醫療照護所需要監督層級的確切敘述。里程碑與可信賴專業活動相輔相成，各有其優點與限制，兩者在國內均有學會採用、推行。臺灣內科醫學會計劃推行里程碑評量，因此瞭解里程碑的發展沿革及里程碑與可信賴專業活動的異同將有助活用兩者，並用來推動與執行以勝任能力為導向的醫學教育。

Competency-based medical education (CBME) emphasizes the physician workforce capable of delivering safe, effective, and unsupervised medical care. It uses an organizing framework of competencies to the design, implementation, assessment, and evaluation of a medical education program. Milestones and entrustable professional activities (EPAs) are two common assessments used for evaluating the competencies or entrusting levels of trainees in CBME. By describing the development of competence, milestones provide a roadmap for programs and trainees, whereas the EPAs detail the competencies required for a specific work. They, therefore, complement each other. Understanding the evolution of milestones and the construction of EPAs will help us to promote and implement CBME in internal medicine.