Many consultant physicians practice general internal medicine in addition to their medical specialty, and many patients are cared for under the umbrella of general internal medicine. These include the full range of adults admitted as emergencies with acute medical problems, ranging from the young fit person with a severe acute illness, to the frail elderly with multiple disorders. Patients with problems that are not clearly within the remit of a particular medical specialty are referred to outpatient clinics for the opinion of a general physician.
Nearly all trainees following the GIM curriculum to CCT will be doing so in parallel with training in another medical specialty. The GIM curriculum defines the competencies needed for the award of a CCT in general internal medicine, which are needed to allow participation at a senior level on the acute medical take, and to provide advice on the investigation and management of inpatients and outpatients with acute and chronic medical problems.
The curriculum reflects the contexts in which GIM is performed, from the admission avoidance clinic to the admitting unit to the inpatient wards and the outpatient clinics. It emphasises the skills and competencies that need to be acquired in these settings and indicates how these will be assessed as trainees progress through the syllabus.
Entry into general internal medicine training is possible following successful completion of both a Foundation Programme and a core training programme. There are two core training programmes in general internal medicine;
- Core Medical Training (CMT)
- Acute Care Common Stem (Medicine) ACCS
The curriculum for each specialty defines the process of training and the competencies needed for the award of a certificate of completion of training (CCT). The curriculum includes the assessment system for measuring trainees’ progress comprising workplace based assessment and knowledge based assessment.
Previous versions of the curriculum are no longer available online but copies can be requested from firstname.lastname@example.org.
The ARCP decision aid for each specialty defines the targets that have to be achieved for a satisfactory ARCP outcome at the end of each training year. ARCP decision aids were revised to reflect the changes to the assessment and review process from August 2014 and replace all previous versions.
The following calculator was put together to allow trainees to calculate their acute medical take and outpatient (or outpatient-equivalent) experience in a manner consistent with the 2009 GIM decision aid that will be used at ARCPs and PYAs. The GIM SAC recommends this to trainees and assessors as an easy means of providing information that is required to inform these assessments, although its use is not mandatory.