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Training pathways


In response to the recommendations set out in the Shape of Training Report and other drivers a new model of physician training that will meet both the future healthcare needs of patients and the service has been developed. Internal Medicine Training (IMT) stage 1 forms the first three years of post-foundation training and, for the main specialties supporting acute medical care, an indicative 12 months of further IMT (stage 2) will be integrated flexibly with specialty training in a dual programme. This model enhances training in Internal Medicine to prepare doctors for the challenge of managing acutely unwell medical patients, who may also have complex presentations based around chronic disease, and comorbidities. Generic professional capabilities (GPCs) as set out in the GMC's framework will be embedded in all curricula to emphasise the importance of these professional qualities as well as helping to promote flexibility in postgraduate training.

The Internal Medicine (IM) stage 1 curriculum was approved by the GMC on 8 December 2017 and replaced Core Medical Training (CMT) from August 2019. A new Acute Care Common Stem Internal Medicine (ACCS-IM) curriculum was also implemented in August 2021. Higher specialty curricula are in development and further information is available on the specialties webpages.

The curricula have been developed with the active input of consultants involved in delivering teaching and training across the UK, trainees, service representatives and lay representatives. This has been through the work of the Specialty Advisory Committees (SACs) and the Curriculum Development Committee (CDC) and regular stakeholder engagement events.

Please see the Internal Medicine Training page for further information and guidance.

Information on arrangements for current trainees to transfer to the new curricula is available here.

Training pathway: Group 1 specialties

Group 1 specialties are the main specialties supporting acute medical care and the majority of training opportunities are in these specialties. IMT will comprise the first three years post-foundation training followed by competitive entry into a group 1 specialty combined with Internal Medicine stage 2 training (dual CCT). An indicative 12 months of IM will be integrated with specialty training in a dual CCT programme. The IM learning outcomes are embedded in the specialty curricula as these capabilities underpin the specialty and must be achieved for CCT in both specialties. It will not be possible to complete training in a group 1 specialty without simultaneously completing training in IM. The overall duration of the training programmes will be detailed in each specialty curricula.

New training programmes will start at ST4 from August 2022.

Group 1 specialties: Acute Internal Medicine, Cardiology, Clinical Pharmacology & Therapeutics, Endocrinology & Diabetes Mellitus, Gastroenterology, Genitourinary Medicine, Geriatric Medicine, Infectious Diseases (except when dual with Medical Microbiology or Virology), Neurology, Palliative Medicine, Renal Medicine, Respiratory Medicine, Rheumatology and Tropical Medicine (except when dual with Medical Microbiology or Virology).

Guidance for implementation of Internal Medicine Training during higher specialty training

Training pathway: Group 2 specialties

A number of specialties managed by JRCPTB will continue to deliver less-acute, primarily outpatient-based services and will not dual train in IM. These specialties will recruit into ST3 posts from IMY2 but trainees who have completed the full three year IMT programme will not be precluded from applying for group 2 specialty training. Alternative core training pathways may be accepted for some group 2 specialties and will be defined in the relevant curricula and person specifications along with the indicative duration of the training programme. Ther new group 2 training programmes started in August 2021.

Group 2 specialties: Allergy, Audiovestibular Medicine, Aviation & Space Medicine, Clinical Genetics, Clinical Neurophysiology, Dermatology, Haematology, Immunology, Infectious Diseases (when dual with Medical Microbiology or Virology), Medical Oncology, Medical Ophthalmology, Nuclear Medicine, Paediatric Cardiology, Pharmaceutical Medicine, Rehabilitation Medicine, Sport and Exercise Medicine, Tropical Medicine (when dual with Medical Microbiology or Virology).

Chemical Pathology, Clinical Oncology, Medical Microbiology, Medical Virology and Occupational Medicine will also recruit trainees who have completed the first two years of IMT. Trainees will also be able to apply for Intensive Care Medicine single CCT training after two years of IMT.