Internal Medicine Training from 2019

The Internal Medicine Training (IMT) programme is a new training model replacing the Core Medical Training Curriculum. It is designed to equip doctors with the skills and confidence to lead on the care of patients in general ward and acute care settings. The curriculum was developed with the active input of consultants involved in delivering teaching and training across the UK, trainees, service representatives and lay representatives. Completing IMT will allow trainees to apply for specialty training in any of the 30 medical specialties ranging from cardiology to aviation and space medicine.

Background to Internal Medicine Training

IMT has been developed as a new training model by the Joint Royal Colleges of Physicians Training Board (JRCPTB), on behalf of the Federation of the three Royal Colleges of Physicians and with the support of Health Education England. This is in response to recommendations in the 2013 Shape of Training Report report to better equip doctors with the skills needed for a 21st Century NHS. For the first time in a physician training programme, experience in outpatient clinics, critical care units and geriatric medicine are mandated and trainees will progress in a structured fashion into their role as the medical registrar. 120 competencies that had to be “signed off” in Core Medical Training are replaced by 14 capabilities in practice, giving a more holistic, authentic and considerably less burdensome assessment strategy, for the trainee and trainer!

Programme Overview

IMT will consist of two stages:

Internal Medicine (IM) Stage 1 training will form the first 3 years of post-Foundation training for most doctors intending to enter Higher Specialty Training in the physician specialties, known as Group 1 specialties. For some specialties, only 2 years of IMT are required, known as Group 2 specialties.

For those specialties dual training with Internal Medicine (Group 1), there will be a further indicative year of Internal Medicine training integrated into Higher Specialty Training. This will be known as Internal Medicine (IM)  Stage 2.

The curriculum for IM Stage 1 has been approved by the GMC. The curriculum for IM Stage 2 is being submitted for consideration by the GMC.

‍

‍

Programme Structure

IM stage 1 training is to help ensure that doctors on the specialist register are competent to practise independently at consultant level in both their specialty and internal medicine. It aims to better 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) will be embedded in all curricula to emphasise the importance of these professional qualities as well as helping to promote flexibility in postgraduate training.

IMT will mandate experience in intensive care medicine, geriatric medicine and outpatients and trainees will receive simulation training throughout the programme. Holistic decisions on progress will be made for the 14 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 previous curricula.

The Acute Care Common Stem (ACCS) and Broad Based Training (BBT) programmes are alternative routes into physician specialties. The curricula are currently under review and the JRCPTB is involved in developing new programmes for ACCS-Acute Medicine and BBT which will comprise an indicative two years common curriculum followed by completion of IMT Year 2 and IMT Year 3.

How will IMT differ to CMT?

• Enhancing morale, values doctors in training and is ultimately better for patients
• Equipping doctors to lead with confidence in the care of general ward and acute take patients
• Better prepare trainees, providing supported progression for the medical registrar role
• This is not just CMT plus one year. This is a completely reformed programme and represents a new era in physician training
• More people training in Internal Medicine and the physician specialties will reduce rota gaps
• Wider exposure to medical specialties including dedicated ICU experience
• Improved access to outpatient experience
• Improved support though a three year programme as they progress through the MRCP Exam.
• Graded and supported increase in responsibility across the programme
• Ensure that Educational Supervisors have access to a training package that will enable them to successfully provide strengthened and focused support  alongside the assessment of the new Generic Professional Capabilities
• A new assessment system will be in place to ensure that IMT trainees are assessed in both formative and summative ways, reducing the concerns about tick-box assessments

Learn More

There are two rounds of recruitment to IMT programmes starting in August 2019:

• Round 1 opened for applications at 10am on Wednesday 7 November 2018 and closed at 4pm on Thursday 29 November 2018.
• Round 2 opened for applications at 10am on Tuesday 26 February 2019 and closes at 4pm on Thursday 14 March 2019.

Your information hub for recruitment to IMT programmes in UK Internal Medicine Training (IMT) can be found here

Further information, including the latest frequently asked questions, can be found on the JRCPTB website here

If you have any questions about the new IM stage 1 curriculum, please contact curriculum@jrcptb.org.uk

Published on behalf of Health Education England

‍