PurposeMultiple studies demonstrate that assessment of residents differs by gender, yet little is known about how these differences are experienced by women and men. The authors sought to understand whether the experience of being assessed and receiving feedback differs between men and women internal medicine (IM) residents and how women respond to these experiences. MethodA constructivist grounded theory approach to data collection and interpretation was used. The authors invited all IM residents in postgraduate years 1-3 at the University of Toronto to participate in semistructured focus groups (August-October 2019). Twentytwo residents participated (8 men, 14 women). Focus groups were divided by gender and training level.

Purpose A key unit of assessment in competency-based medical education (CBME) is the entrustable professional activity. The variations in how entrustment is perceived and enacted across specialties are not well understood. This study aimed to develop a thorough understanding of the process, concept, and language of entrustment as it pertains to internal medicine (IM). Method Attending supervisors of IM trainees on the clinical teaching unit were purposively sampled. Sixteen semistructured interviews were conducted and analyzed using constructivist grounded theory. The study was conducted at the University of Toronto from January to September 2018. Results Five major themes were elucidated. First, the concepts of entrustment, trust, and competence are not easily distinguished and sometimes conflated. Second, entrustment decisions are not made by attendings, but rather are often automatic and predetermined by program or trainee level. Third, entrustment is not a discrete, point-in-time assessment due to longitudinality of tasks and supervisor relationships with trainees. Fourth, entrustment scale language does not reflect attendings’ decision making. Fifth, entrustment decisions affect the attending more than the resident. Conclusions A tension arises between the need for a common language of CBME and the need for authentic representation of supervision within each specialty. With new assessment instruments required to operationalize the tenets of CBME, it becomes critically important to understand the nuanced and specialty-specific language of entrustment to ensure validity of assessments.