Core competencies and Milestones have formed the foundation for curriculum and assessment in family medicine training for more than a decade. Understanding the rationale for these components provides programs with a basis for ongoing development and program improvement. Entrustable professional activities can be a strong work-based tool linking Core Competencies and Milestones to concrete professional activities. Successful programs are able to use the Core Competencies and Milestones to identify curriculum gaps and improve assessment processes. With a shifting focus within graduate medical education (GME) to more learner-centered practices, understanding the role of these components in individual learning plans, promotion decisions, and outcomes-based education models is vital to meet the Accreditation Council of Graduate Medical Education and American Board of Family Medicine requirements for accreditation and board eligibility, respectively. This chapter takes educators and learners through the basic tenets of the Core Competencies, Milestones, and entrustable professional activities and how they relate to each other. The focus then shifts to the incorporation of these components into the review and refinement of curricular gaps, resident assessment, remediation, and promotion, and the role of clinical competency committees’ responsibilities. Finally, common pitfalls and pearls for real-world application and future directions are discussed.