New Internal Medicine curriculum

Internal Medicine stage 1 curriculum

The Federation of Royal Colleges of the UK is delighted to announce that the new Internal Medicine (IM) stage 1 curriculum has been approved by the General Medical Council (GMC).

This new curriculum focusses on the achievement of high level capabilities in practice (CiPs), successfully moving away from the often criticised ‘tick box’ approach for previous curricula. It will produce doctors with the skills needed to manage patients presenting with a wide range of general medical symptoms and conditions which will address the future workforce needs as set out in the Shape of Training report. The curriculum also incorporates the GMC's generic professional capabilities (GPCs) to emphasise the importance of these professional qualities as well as helping to promote flexibility in postgraduate training.

The curriculum was developed with the active input of consultants involved in delivering teaching and training across the UK, trainees, service representatives and lay persons. This has been through the work of the Internal Medicine Committee (IMC) and its subgroups and at regular stakeholder engagement events. A 'proof of concept' study was conducted in 2016 and a wide consultation exercise was carried out in 2017 to ensure the curriculum is fit for purpose and deliverable across the UK.

The IM stage 1 programme will comprise the first three years post-foundation training, during which there will be increasing responsibility for the acute medical take and the MRCP(UK) Diploma will be achieved. It will include mandatory training in geriatric medicine, critical care, outpatients and ambulatory care. IM stage 1 training will replace core medical training (CMT) from August 2019. We will be working closely with heads of schools, training programme directors and trainee committees to support the implementation of the new curriculum. We are also working with other colleges to ensure the ACCS-Acute Medicine curriculum is updated to reflect the new programme. 

PDF icon Implementation of Internal Medicine stage 1 curriculum briefing

PDF icon Internal Medicine stage 1 curriculum

Future training pathway for physician specialties

JRCPTB, on behalf of the Federation of Royal Colleges of Physicians, has produced a model for physician training that consists of an indicative seven year (dual) training period leading to a CCT in a specialty and internal medicine. Stage 1 training in internal medicine will comprise the first three years post-foundation training followed by competitive entry into specialty plus internal medicine dual training (see training pathway for group 1 specialties). A minimum of three years will be spent training in the specialty (there will be variation across specialties) and there will be a further one year of internal medicine integrated flexibly within the programme. This will ensure that CCT holders are competent to practice independently at consultant level in both their specialty and internal medicine.

This model will enhance the training in internal medicine for all physicians. In particular, it will promote the management of the acutely unwell patient with an increased focus on chronic disease management, comorbidity and complexity in the main specialties supporting acute hospital care.

Model for physician training - Group 1 specialties (dual CCT)

A number of specialties managed by JRCPTB will continue to deliver non-acute, primarily outpatient-based services (see training pathway for group 2 specialties). These specialties will recruit into ST3 posts from IM2. Trainees who have completed the full three year IM stage 1 programme will not be precluded from applying for group 2 specialty training. Alternative core training pathways may be accepted for some physician specialties and will be defined in the relevant curricula.

Model for Physician training - Group 2 specialties (single CCT)

A list of specialties that will dual train with internal medicine (group 1) and those that will not (group 2) is given below.


December 2017: Interview with Professor David Black, JRCPTB Medical Director

Dr Carol Postlethwaite and Dr Orod Osanlou of the Royal College of Physicians of London Trainee Committee met with Professor David Black to discuss the newly approved Internal Medicine curriculum.

July 2016: Interview with Professor David Black, JRCPTB Medical Director

Dr Katherine Walesby, chair of the Royal College of Physicians of Edinburgh Trainee and Members' Committee and current Clinical Research Fellow and medical registrar in Geriatric Medicine, met with Professor David Black to discuss many of the questions that physicians in training have about the proposed Internal Medicine curriculum and its potential impacts on the structure and assessment of medical training.
The full video is available to watch on our YouTube channel.