Acute Internal Medicine (AIM) is concerned with the assessment, diagnosis and management of adults presenting to secondary care with acute medical illness. There is a broad spectrum of clinical work within the specialty and trainees will acquire competencies relevant to:
- the prompt practical management of acute presentation of medical illness
- the management of medical patients in an in-patient setting
- the development of new patient pathways to maximise safe, effective care in the community where feasible
- the provision of leadership skills within an acute medical unit
- the development of multi-professional systems to promote optimal patient care
- the care of patients requiring more intensive levels of care than would be generally managed in a medical ward. These competencies are generally acquired from experience within a critical care unit.
All trainees in AIM must develop a specialist skill. These generally fall into one of four categories:
- Procedural skill (eg: echocardiography)
- Additional qualification (eg: medical education)
- Speciality interest (eg: intensive care medicine)
The complete list of specialist skills with links to further information can be found in the forms and guidance section of this webpage. Trainees wishing to apply for a skill which is not on the list should contact Felicity Stuart (email@example.com) the AIM SAC Committee Manager.
Entry into acute 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 acute internal medicine:
- Core Medical Training (CMT)
- Acute Care Common Stem - Acute Medicine (ACCS-AM)
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.
Information on the Specialty Certificate Examination (SCE) in Acute Internal Medicine can be found on the MRCP(UK) website.
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. The version below has been updated further to discussion at the AIM SAC and replaces all previous documents from August 2017. The changes include:
- Improved guidance notes
- Clarification that ACATS should each include a minimum of 5 cases
- Guidance on sampling and sign off of curriculum competencies
- Corrected procedural requirement for intercostal drainage (1) for pneumothorax - clinical independence is required by end of ST3 (as per curriculum and eportfolio)
- Corrected procedural requirement for intercostal drainage (2) for pleural effusion - clinical independence is required by CCT (as per curriculum and eportfolio)
- Footnotes revised to include clearer definition of clinical independence and to reflect the British Thoracic Society guidelines on ultrasound for pleural procedures
The complete list of Acute Medicine specialist skills can be found here: Specialist Skills for Acute Internal Medicine.pdf
Specialty placement checklists
The top presentations and other important presentations (as defined in the curriculum) have been mapped to specialties to provide guidance for trainees and supervisors. Checklists have been produced for the specialty placements in CMT and AIM where trainees are likely to encounter five or more presentations. The mapping document and checklists can be used as guides help identify educational objectives and inform the personal development plan. The checklists can be used to record which presentations were explored during the placement and supervisors can comment on what went well, any areas which need further development and agree an action plan with the trainee. The checklists can be helpful when reviewing trainee’s progress and adding ratings for top and other important competencies at group level.
The checklists are available in MS Word format so they can be edited and uploaded to the ePortfolio - see the table below. The overall mapping document is available here: Mapping of presentations in CMT and AIM to specialties.pdf.
Checklists for CMT and AIM specialty placements