General (Internal) Medicine

Before the trend to specialisation, although many consultant physicians developed an expertise in their chosen areas, most practiced general internal medicine and dealt with a wide range of medical problems. These included patients admitted as emergencies, patients with multiple disorders, patients referred to outpatient clinics for investigation and diagnosis, and patients referred by specialist services - as outpatients or urgent inpatient referrals.

The demands of admitting and managing acutely ill medical patients have spawned a sub-specialty within General Medicine.   Acute Medicine has been established to improve the quality and safety of care for people who are acutely ill. It is defined in the RCP's report Acute Medicine - Making it Work for Patients as: 'That part of general (internal) medicine concerned with the immediate and early specialist management of adult patients with a wide range of medical conditions who present in hospital as emergencies.'    Details about Acute Medicine can be found on this site at the top of the 'specialties' list.

To complicate things further we are working towards establishing Acute Medicine as a full specialty ultimately replacing GIM.   For legislative reasons we cannot simply substitute one for the other so, in order to establish the new curriculum for Acute Medicine, we have combined both titles into one - GIM (Acute Medicine).   As can be seen from the variations in training pathways explained in the next section, there will be two distinct groups of trainees doing 'GIM'.   The first group are those already holding NTNs who are working to the current GIM curriculum towards a CCT + another specialty.   The second group will be those entering training under the run-through grade who will either pursue GIM (Acute) from ST1 to CCT and become Acute Medicine specialists leading MAUs, or those pursuing another specialty (for example Cardiology) and level 2 GIM (Acute).   Trainees in the latter category will not usually dual CCT in a specialty and GIM (Acute) in the traditional way; but will complete training in their main specialty with credential at level 2 of the GIM (Acute) curriculum, thus providing them with the relevant qualifications to participate in, but not specialise in leading, the acute take.

Due to regular revisions, arising from changes in the training environment and the demands of the PMETB, the JRCPTB are currently running various curricula for trainees in each specialty.  All relevant curricula are listed at the bottom of this page under Documents.  Use the filter option on the right-hand side, together with the guidance notes below,  to help you select the correct document.  In summary:

• If you are a run-through (Specialty Registrar [StR]) trainee, you will follow the curricula tagged as ST3+

• If you are an ‘old style’ SpR, you are following the curricula tagged as SpR

• If you enrolled prior to 01/01/03, you will be following the original curricula which are no longer available for download, see note below

 
Competence based curricula – ST3+

ii) General Internal Medicine (Acute) Competence Levels 1,2 & 3 Curriculum for those pursuing a CCT in GIM (Acute) OR General Internal Medicine (Acute) Level 1&2 Curriculum for those undertaking training in another specialty and credential at level 2. 

Competence based curricula – SpR (for trainees enrolling after 1 Jan 2003)

The JCHMT introduced revised curricula for all the medical specialties together with a generic curriculum that applied to all trainees back in 2003. These are competence-based and set out the knowledge, skills and attitudes to be acquired by trainees before they may be awarded a CCT.

Curricula (for trainees enrolling before 1 Jan 2003)