Internal Medicine

About the specialty: 

Internal Medicine Training (IMT) forms the first stage of specialty training for most doctors training in physicianly specialties and will prepare trainees for participating in the acute medical take at a senior level and managing patients with acute and chronic medical problems in outpatient and inpatient settings. The curriculum for IMT stage 1 was approved by the GMC in December 2017 and IMT replaced Core Medicial Training (CMT) from August 2019. Trainees must complete IMT and acquire the full MRCP(UK) Diploma in order to enter specialty training at ST4 from 2022. Some specialties (group 2 specialties) will recruit trainees who have completed two years of IMT and completed MRCP(UK) at ST3 level. 

IMT is a three year programme which will prepare doctors to become a medical registrar and provide them with the skills needed to manage patients presenting with a wide range of general medical symptoms and conditions. Experience in intensive care medicine, geriatric medicine and outpatients will be mandated and trainees will receive simulation training throughout the programme. Holistic decisions on progress will be made for the fourteen high level capabilities in practice (CiPs) using the professional judgement of appropriately trained, expert assessors. This represents a significant move away from the much criticised ‘tick box’ approach of the CMT curriculum.

Please see the forms and guidance section below for resources to support implementation of the curriculum.  Related FAQs can be accessed via the links section

Acute Care Common Stem (ACCS)

The new curriculum for ACCS will replace the current curriculum from August 2021 subject to final GMC approval. Doctors will rotate through specialty placements in Emergency Medicine, Internal Medicine, Anaesthetics and Intensive Care Medicine. Trainees on the ACCS-Internal Medicine (ACCS-IM) programme will then undertake IM year 2 and 3 training to complete the core training programme. Trainees will be eligible to apply for all group 1 JRCPTB specialties following completition of the ACCS-IM programme or can apply for a group 2 (non acute) specialty can do so after three years of ACCS-IM (ie completion of IMY2).

Please see the ACCS page for further information.


The purpose of this curriculum is to define the process of training and the competencies needed for the successful completion of Internal Medicine Training

 Curriculum for Internal Medicine Stage 1 Training

ARCP Decision Aids: 

The ARCP decision aid defines the targets that have to be achieved for a satisfactory ARCP outcome at the end of each training year for trainees in IMT and for trainees in CT3 ACCS-Acute Medicine. Please see the Covid-19 page for additional guidance on ARCPs and trainee progression.

PDF icon IMT ARCP Decision Aid 2019

The Internal Medicine Core Medical Training Advisory Committee (IMCMTAC) recommends using structured checklists to support the interim review of competency process in IMT. You should complete the checklist with your educational supervisor in December, although there will be some local variation in timing. Support is available from your local College Tutor and Training Programme Director.

File IMT Interim Checklist IMY1

File IMT Interim Checklist IMY2

Forms and guidance: 

Information and guidance

Information and guidance on ST3 recruitment in 2021 and expresssions of interest in an IMY3 is available via this link

The slide set below provides information about the internal medicine stage 1 curriculum including the training requirements, capabilities in practice and the programme of assessment.

PDF icon IMT stage 1 curriculum information

The rough guide to IMT provides guidance on the practical aspects of implementing the new curriculum including transition guidance for trainees who have completed CMT or ACCS-AM.

Rough guide to Internal Medicine Training - May 2020

Guidance for completing IMT in less than 36 months

PDF icon Completing Internal Medicine Training in less than 36 months

Calculating acute take/outpatient experience and recording procedures

The following template can be used to calculate acute take experience and record outpatient clinics and procedures undertaken in IMT. The totals calculated should be used to populate the IMT summary of clinical activity and teaching form on the ePortfolio.

File IMT acute take calculator and log of clinics and procedures 2019

Outpatient experience

Requirements for Outpatient experience in Internal Medicine (IMS1) Training

Example Educational Supervisor report

PDF icon Example Educational Supervisor report for IMY2 clinical CiPs


We have provided a template welcome letter for new IMT trainees for schools of medicine to use locally. The induction checklist can be used as an aide memoire by educational supervisors to prepare for and carry out an induction meeting. 

File IMT Trainee Welcome Letter.docx

File Induction Checklist


This video gives you a brief overview on how to navigate the ePortfolio.

The document below explains the changes we have made to support the new curriculum. 

PDF icon ePortfolio for IMT.pdf

PDF icon ePortfolio for IMT.pdf

IMY3 preferencing

The document below provides guidance on the proposed IMY3 preferencing process.

PDF icon IMT Stage 1 programme preferences guidance

IMT work schedule

In conjunction with NHS Employers we have introduced the new work schedule for IMT. The schedule is designed to help employers plan and deliver clinical services alongside training programmes in a way that is safe for both doctors and patients. Work schedules are a contractual requirement in England and are not required by the devolved nations at present but are considered as good practice.

File Work schedule for internal medicine stage 1