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. 

New GIM Curriculum 2009 

Following on from the statement released on 5^th February 2009 by the Joint Royal Colleges of Physicians Training Board (JRCPTB) regarding plans to reinstate the system for award of dual certificates of completion of training (CCTs) in General Internal Medicine (GIM) and acute Medical Specialties, the JRCPTB is pleased to announce the new curriculum for General Internal Medicine. This curriculum, from August 2009, will replace the GIM (Acute) Medicine (2007) curriculum and will allow trainees once again to achieve a dual CCT in their specialty and General Internal Medicine.

The current GIM (Acute) Medicine Curriculum was introduced in 2007 to satisfy the demand for physicians trained with appropriate skills to lead acute medical admission units.  It explicitly stated how progression would occur through the different levels of the spiral curriculum. Level 1 competences were to be achieved during Core Medical Training before entry to Specialist training.  Achievement of Level 2 competences would be recognised by the award of a credential that confirmed the trainee’s acquisition of competences to allow participation as a Consultant in the acute medical take. Level 3 competences were defined specifically for trainees in Acute Medicine training programmes, who would be the leaders and mainstay of acute medical units. 

This new curriculum has been produced to meet the increasing needs of patients as identified by the service, for physicians to manage and enhance patient care in the acute medical units. It also addresses the concerns of trainees. Trainees recruited in 2007 and 2008 expressed the wish to be able to achieve dual CCT’s in GIM and another acute medical specialty as they were concerned that without a CCT for GIM, their competence to participate in the acute medical take might be called into question.

The new curriculum differs from the GIM (Acute) Medicine (2007) curriculum in that it better defines the need to demonstrate maturation of the trainee’s competences through the duration of training.  In Core Medicine the trainee is expected to be able to recognise and diagnose the common medical conditions. In subsequent training in GIM, the trainee builds on the core competences, as they acquire skills in the treatment and management of complex medical problems in both in-patient and out-patient settings. There is a greater emphasis on the need to understand the use of pharmacological agents and their complications in patients with multi-system disease.

The JRCPTB has ensured that PMETB’S quality standards will be met, while still emphasising the need for progressive acquisition of competences in the ‘Top 20’ Common Presentations and Other Important Presentations. The previously separate “Generic Curriculum” has also been incorporated into the main body of the curriculum. This early use of the has allowed the mapping of assessments to the General Medical Council domains of Good Medical Practice and is a significant advance.

The JRCPTB wishes to ensure those trainees who are signed up to the current GIM (Acute) Medicine Curriculum (2007) (i.e. all those trainees who commenced training in GIM together with their chosen medical specialty in 2007 and 2008) are not perceived to be disadvantaged by not having the appropriate dual CCT qualifications. Trainees who wish to transfer to the new curriculum will be able to do this by providing the appropriate evidence as detailed in the curriculum.  Please see the flowchart for details on how to transfer. 

JRCPTB looks forward to implementing this new curriculum, building on our existing commitment to develop high quality training for physicians in this most fundamental of all our specialties. 

Process on how to transfer to the new GIM curriculum

Flowchart on how to transfer to new GIM curriculum

Application Form to request transfer to GIM curriculum

ARCP transfer Proforma

Frequently asked questions for trainees  

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 (entry 01 August 2007 and entry 01 August 2008), you will have been following  the curriculum tagged as General (Internal) Medicine (Acute Medicine) ST3+, but should now transfer to the 2009 General Internal Medicine curriculum.

• If you are an ‘old style’ SpR (entry pre August 2007), you should be following the curriculum tagged as SpR (01 January 2003).  You will not need to transfer to the 2009 curriculum.

• If you entered training prior to 01 January 2003, you will be following the original curriculum (July 1998) which is no longer available for download, see note below.