Shape of Training and the physician training model


In response to the recommendations set out in the Shape of Training Report and other drivers, we have developed a model for future physician training. Internal Medicine Training (IMT) will form the first three years of post-foundation training and, for the main specialties supporting acute hospital care, an indicative 12 months of further internal medicine training will be integrated flexibly with specialty training in a dual programme. This model will enhance the training in internal medicine and will prepare doctors for the management of the acutely unwell patient, with an increased focus on chronic disease management, comorbidity and complexity. 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 will be 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

Training pathway: Group 1 specialties 

Group 1 specialties are the main specialties supporting acute hospital 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 plus internal medicine (dual CCT). An indicative 12 months of internal medicine will be integrated with specialty training in a dual CCT programme. The overall duration of the training programmes will be detailed in each specialty curricula. New trainining 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).

Training pathway: Group 2 specialties 

A number of specialties managed by JRCPTB will continue to deliver non-acute, primarily outpatient-based services and will not dual train in internal medicine. 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. The indicative duration of the training programmes will be detailed in each specialty curricula. New trainining programmes will start from 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.


The diagram below sets out the timeline for recruitment and transition. Further information on recruitment in 2021 and transitional arrangements for trainees already in training will be provided as more information becomes available. 

Credit to James Bradley-Watson of the British Junior Cardiology Association