Internal Medicine Training (IMT)
When will IMT be implemented?
IMT will be implemented in August 2019 and there will be no further recruitment to CMT. There will be phased implementation of the full training model with new curricula for group 2 specialties starting in 2021 and group 1 specialties in 2022.
How will IMT differ from CMT?
IMT will be a three year programme which will deliver the following improvements:
- supported transition to the medical registrar role
- a more structured programme with mandatory training in geriatric medicine, critical care and outpatients
- longer placements in IMY3 to provide more continuity in training
- simulation based learning
- a programme of assessment which is holistic and intuitive
- additional time in which to gain MRCP if needed
How will trainees gain wide experience across all specialties?
There will be mandatory training in geriatrics and critical care but there will still be opportunity to gain a wide range of experience over the three year programme. Flexibility in delivery of the curriculum will allow each HEE local office or deanery to offer a range of rotations.
How will the IMY3 year differ from ST3?
The new programme will better prepare trainees for the role of the medical registrar. There will be a critical progression point at the end of the second year (IMY2) to ensure trainees have the required capabilities and are entrusted to ‘step up’ to the medical registrar role in IMY3. For most, the trainee will be entrusted to manage the acute unselected take and manage the deteriorating patient with indirect supervision. For a few, this will be for a period of time in a supportive training environment with the supervising physician readily available.
Will there be training in how to use the new curriculum and outcomes based assessment system?
Yes, there will be hands on training sessions in every school of medicine using materials developed by JRCPTB with input from trainee and trainer representatives. Core faculty in each region will be trained in early 2019 and will cascade training in time for implementation of the new curriculum in August 2019. There will be a rolling programme of training to prepare for implementation of the specialty curricula in 2021-2022. The training for the core faculty will be delivered by experienced educationalists and clinicians and comprehensive distance teaching resources will be provided.
How do I apply for IMT?
Information on applying for IMT and ACCS acute medicine is available on the IMT recruitment website. The recruitment process section of the website guides you through a recruitment round, including dates and posts, eligibility criteria, planning your application, applying, interviews and offers.
When will I be able to see what IMT programmes are on offer?
All regions have provided full rotation information for the first two years of the programme, including the hospital, specialty information and duration of each post. IMY3 will be within the same region as IMY1/IMY2 and some regions will be providing specific information about programmes when preferences are selected. All regions will provide more information for their programmes over the coming months. Please see the IMT recruitment website for further information.
How will I be allocated to IMY3?
Each school will manage a locally-run process for allocating rotations for IMY3. The principles for this process are:
- The training programme director (TPD) for Internal Medicine will hold interim reviews in IMY2 to gauge whether trainees are likely to undertake IMY3
- The TPD and workforce team will request preferences for the available rotations from all trainees considering a progression into IMY3
- Specialty training undertaken in IMY3 will not be taken into consideration in the selection process for ST4 higher specialty training and trainees can use IMY3 as an opportunity to experience a specialty complementary to their chosen career path
- When finalising allocations, the TPD/s will take into account the learning needs of the trainee and the service provision requirements across the region.
A guidance document is available here.
I am interested in a non-JRCPTB specialty which currently requires CMT for entry at ST3. Will I need to complete IMT?
All specialties will be producing new curricula and will define the entry criteria for higher training. We anticipate that most non-physician specialties which currently accept CMT will require two years of IMT but recommend that you check the person specification at the time of application.
What will be the duration of the total training programme in each specialty?
All JRCPTB specialties are in the process of producing new curricula in line with the model for physician training. The overall length of training for group 1 specialties will be the same as for current dual training programmes with GIM. As an example, currently dual training in Geriatric Medicine and GIM comprises two years CMT plus five years higher specialist training, so seven years in total. In future, dual training will become three years IMT plus four years HST so still seven years in total. The exception to this will be the three specialties which will be dual training with IM for the first time – Genitourinary Medicine, Palliative Medicine and Neurology – which will gain one year in overall duration.
Training in group 2 specialties will be the same length as current training.
Acute Care Common Stem - Acute Medicine (ACCS-AM)
Will there be a new training programme for ACCS-AM?
ACCS-AM is a core programme for all JRCPTB specialties. The ACCS curriculum is currently under review and the JRCPTB is involved in developing a new programme for ACCS-AM which will comprise an indicative two years rotating through Emergency Medicine, Acute Internal Medicine, Anaesthetics and Intensive Care Medicine followed by completion of IMY2 and IMY3 (four years in total). This will ensure trainees are eligible for entry to group 1 specialties. It is anticipated that the ACCS curriculum will be implemented in 2021 and there will be transitional arrangements for trainees already in ACCS-AM programmes.
What is the application process for academic programmes?
Academic programmes will be advertised and recruited to by each region. Candidates should apply directly but will also need to go through the IMT recruitment process to confirm eligibility for IMT if they are appointed at ST1 or ST2 level. The length of the IMT element of the run through programme will depend on whether the academic programme is in a group 1 or group 2 specialty and applicants should check the detail of the individual programme. Some regions offer academic core programmes and these may vary in length – please refer to the employing body for information.
How will the change affect doctors who are currently in academic training programmes?
Academic programmes starting at ST1 currently include CMT as part of a run through programme and trainees enter specialty training at ST3 after two years of CMT. Trainees who do not move into higher training by 2021 will require IMY3 training and this will be arranged by the HEE local office/deanery. A training needs analysis will be carried out to determine the training and experience required to complete the new curriculum requirements and there will be guidance available to support this process.
Group 1 / group 2 specialties
When do I need to decide whether I want to apply to a group 1 or 2 specialty?
Trainees will be appointed to three year IMT programme. Training programme directors will discuss your career intentions with you to help advise you and to allow for programme planning. You can choose to leave the programme after IMY2 whether or not you are successfully appointed to a group 2 specialty or stay and complete IMY3.
Can I complete all three years of IMT and still apply to a group 2 specialty?
Yes you will still be eligible to apply for group 2 specialties and you may wish to complete the full three year programme to give you flexiblity to apply for any specialty. Trainees will not be disadvantaged if they do not complete IMY3 if the entry criteria for a specialty only requires completion of the first two years of IMT.
Will it be possible to train in infectious diseases and medical microbiology if infectious diseases is a group 1 specialty?
The training programme for dual training in infectious diseases with medical microbiology or virology is still under discussion but it is currently expected that trainees will be able to enter dual training after IMY2.
Will medical oncology be a group 1 or group 2 specialty?
It has been confirmed with the GMC’s Curriculum Oversight Group (COG) that medical oncology will be a group 2 specialty. We are working closely with the Royal College of Radiologist to develop a curriculum which includes an indicative year of joint training with clinical oncology.
If I apply in 2021 for the final year of ST3 recruitment to Neurology, Genitourinary Medicine or Palliative Medicine will I be required to transfer to the new curricula after 2022?
It is expected that there will be a final year of recruitment to ST3 in these specialties in 2021. The GMC requires doctors to train to the most current curricula and usually requires trainees to move to a new curriculum within two years of implementation. The transitional arrangements for these specialties will need to be determined and will be published.
Training in Intensive Care Medicine (ICM)
Will it be possible for trainees in group 1 specialties to train in ICM if they are dual training in IM?
We are currently working with the Faculty of Intensive Care Medicine and the GMC to support the physician specialties of Acute Internal Medicine, Renal Medicine and Respiratory Medicine continuing to train in ICM. Further information will posted on the JRCPTB and FICM websites when available.
Transition for current CMT and ACCS-AM trainees
Will I need to complete IMY3 if I leave CMT or ACCS-AM and do not enter specialty training before 2022?
The entry requirements for group 1 specialties from 2022 will require completion of full IMT or equivalent. Trainees who have completed CMT or ACCS-AM will require IMY3 training and this will be arranged in the region in which CMT/ACCS was completed. There will not be a competitive recruitment process for this group of trainees.
If I undertake a IMY3 during the transition period will I need to meet all the IMT training requirements?
Anyone requiring IMY3 training in the transitional period will have a training needs analysis to determine what training and experience is required to meet the curriculum capabilities. There will be national guidance to support this process.
Will CMT/ACCS-AM trainees be able to apply for ST3 posts in 2021?
There will be recruitment to group 2 specialties in 2021 and it is anticipated that there will be limited recruitment to ST3 in a small number of group 1 specialties. Further details will be available closer to the recruitment period.
Will all group 1 speciality training programmes start at ST4 level from August 2022 onwards?
Yes, all recruitment to group 1 specialties will be at ST4 from 2022. IMY3 will not be included in specialty programmes and should be undertaken prior to application.
How will the change affect doctors who are training less than full time?
CMT/ACCS-AM trainees who are currently training less than full time and will not complete before 2021 will be eligible for IMY3 training in the same deanery.
Trainees will be entitled to opt for less than full time training in IMT. Less-than-full-time trainees will be required to undertake out of hours duties (including on call) based on the proportion of a doctor's full-time commitment to the same rota. This will be subject to discussion with your employer and local training provider as per the current process.