It is a requirement for all HST applicants to have achieved capability to the level described on the person specification. 

These are divided into two categories, in line with the two levels of training in the UK between primary medical training (ie medical school) and higher specialty training (HST): foundation competences and core capabilities.

Foundation competences

For recruitment purposes, it is not necessary to demonstrate your achievement of foundation competences. If you can demonstrate achievement of core capability, it will be taken you have also gained the necessary foundation competences.

Core capability

The way in which this is demonstrated varies depending on the previous training of the candidate. There are five main categories of candidates and a section explaining what this means and how core capability can be demonstrated:
  • Current core - this will depend on whether the specialty is a group 1 or group 2 specialty (see the JRCPTB website for details):

    • Group 1 specialties - candidates currently on the third year of a UK internal medicine training or fourth year of an ACCS internal medicine programme; JRCPTB internationally level 3 accredited equivalents of internal medical training are considered equally.

    • Group 2 specialties - as per Group 1, except this also applies to those in the second year of a UK internal medicine training programme or third year of an ACCS internal medicine programme.
  • Completed core - candidates who have completed UK internal medicine training or ACCS acute medicine training programme to the required level by the time of application; as above, JRCPTB internationally level 3 accredited equivalents of UK core training can be considered equally to the UK equivalent 

  • Non-physicianly training - candidates applying to HST in specialties which accept trainees from 'non-physicianly' training routes

  • Alternative - candidates who do not fit into one of the above categories

  • Refugee doctors - candidates with exceptional circumstances that prevent them from supplying the standard evidence; in most cases, this will be because they are a refugee but could include other candidates if they have very exceptional circumstances.

Providing evidence

All candidates except those on a pre-HST UK medical training programme, or who have exceptional circumstances, will be required to upload evidence of their core competences with their application. The 'Providing evidence' section of this page has guidance on how this is done on the Oriel system.


Candidates currently in UK core medicine programmes

There are three potential UK core medicine programmes from which a trainee could apply to higher specialty training as a 'current core' trainee. This page details the programme and the requirements for both Group 1 and Group 2 specialties. 

All who apply as a current core trainee, will not need to provide any  evidence of achievement of core capability at time of application, just  give details of your current training status.

Internal medicine training (IMT)

  • Group 1 - you can only apply as a current core trainee if you are on track to successfully complete IMY3 (ARCP outcome 6)  by time of the  advertised post commencing from  date.
  • Group 2 - this applies to those who are applying direct from IMY2 and on track to successfully complete IMY2 (ARCP outcome 1) by the posts commencing from date. If you are a current IMY3 applying to a Group 2 specialty, you should select on the application form that you are a current core trainee.

Acute care common stem: internal medicine (ACCS-IM)

This programme is in the process of a name change from ACCS acute medicine and the guidance applies equally.

  • Group 1 - you can only apply as a current core trainee if you are on track to successfully complete the fourth year of ACCS-IM (the equivalent to IMY3)  by time of the  advertised post commencing from  date.
  • Group 2 - you can apply as a current core trainee if you are track to successfully complete the third year of ACCS-IM by the posts commencing from date. If you are an ACCS-IM trainee in your fourth year and applying to a Group 2 specialty, you should select on the application form that you are a current core trainee.

Core medical training (CMT)

CMT is the forerunner of IMT and there are very few trainees left on this programme. 

  • Group 1  - CMT trainees are not eligible to apply for a Group 1 specialty on the basis of completing CMT. They will either need to complete an IMY3 stand alone training programme, or gain equivalent experience and capability in a non-training programme role. 
  • Group 2  - you can apply as a current core trainee if you are on track to successfully complete the second year of CMT by the posts commencing from date. 

Stand-alone posts

Undertaking a stand-alone core training year, e.g. an IMY3 programme, does not affect how you demonstrate your core capability. You can answer in the same way as someone in the same year of training who started from CT1 and you need only give details of your training in your application form.

JRCPTB internationally level 3 accredited training

The JRCPTB accredits training outside the UK as meeting the standards set by the Federation of the Royal Colleges of Physicians of the United Kingdom. Where a programme has been given  level 3 accreditation as equivalent to UK core training , this will be accepted as a direct alternative to UK training.

If you are training in one of these programmes, you will be eligible to apply provided that you can show that your training progress to date has been satisfactory and that you are on track to gain all core competences by the  advertised post commencing from  date.

As the application form has been designed for UK trainees, you will need to answer no to all the competence questions until a text box asks you to explain why you are unable to supply standard documentation. You can then explain your circumstances so the recruitment team know you are entering via your internationally accredited training; you will not need to supply any documentation until later in the process as part of pre-employment checks.

Completion of core training delayed due to deferral

The start of training may only be deferred on statutory grounds (e.g. maternity leave, ill-health). Please see the Gold Guide for further information.

This includes a period of illness or maternity leave taken during core training prior to making an application. Where applicants are unable to achieve capability on time, they may still apply whilst they complete the time/areas missed. Extended training will need to be organised in the current post to cover the time that was missed. 

Under these circumstances, you would not need to submit evidence of core capability at the time of application.

Upon receiving an offer, you should contact the region managing your application to ensure they are aware of your desire to defer your start date and ensure this will be permissible. The final decision on whether a start date can be deferred is at the discretion of the region.

Candidates who have already completed pre-HST UK medical training

If by the time of application you have already completed internal medicine training, core medical training or an ACCS internal medicine programme, you can use this to demonstrate core capability. You will be required to attach an electronic version of your ARCP confirming completion. Please note it is possible to download a PDF version of your ARCP outcome from the ePortfolio system.

Trainees in IMY3 applying to a Group 2 specialty

If this applies to you, although you will probably have already completed the element of the core training programme required to enter this specialty, you should answer on your form that you are a current core trainee and there is no need to supply any evidence of core capability when you apply. This also applies to trainees in the fourth year of an ACCS-IM programme.

Not yet completed the MRCP(UK)

If you have not yet gained the full MRCP(UK) diploma, but have otherwise successfully completed core training to the required level, you can still apply. You will be required to attach the electronic version of evidence of completion of training (i.e. your ARCP) and then in the MRCP(UK) status section, you can confirm which parts of the examination you have completed and which are outstanding; you must be able to complete outstanding sections by the advertised post commencing from date.

JRCPTB internationally level 3 accredited training

The JRCPTB accredits training outside the UK as meeting the standards set by the Federation of the Royal Colleges of Physicians of the United Kingdom. Where a programme has been given level 3 accreditation as equivalent to UK core training, this will be accepted as a direct alternative to the UK equivalent.

If you have completed training in one of these programmes, you will be eligible to apply and will demonstrate this by attaching your ARCP documentation to your application in exactly the same way as detailed above for UK trainees.

Please note that trainees completing a core medical training programme will only be eligible to apply on this basis for Group 2 specialties. Eligibility for Group 1 specialties requires completion of IMY3 equivalent training and the Alternative Certificate to Enter Group 1 Higher Physician Specialty Training.

Alternative certificate to enter higher physician specialty training

If you have not completed, or will not complete, a pre-HST UK training programme which is valid for the specialty to which you are applying, you will need to take alternative steps to demonstrate your achievement of core capability.

Alternative certificate

The only alternative method for physician applicants is to use what is called an 'alternative certificate'. There are two versions of this certificate, which can be downloaded from the document library.

  • Alternative Certificate to Enter Group 1 Higher Physician Specialty Training - this can be used for entry to Group 1 and Group 2 specialties, there is no need to submit a Group 2 version if you have the Group 1 completed.
  • Alternative Certificate to Enter Group 2 Higher Physician Specialty Training - this can only be accepted for Group 2 specialties and it will be necessary to get a Group 1 certificate signed if you wish to apply to one of those specialties.

The certificate provides a list of the core capabilities that are required by the IMT programme, and necessary to enter HST. 

Unless you have exceptional circumstances, the form must be fully completed and attached to your application form for you to be eligible. The document itself gives some advice on its use and completion, but we have also added some further guidance below.

A single version of the 2022 certificate only

Please note that only the 2022 version of the certificates are currently permissible. Previous versions of the certificate will not be accepted. Please also be aware that you may only submit one version of the certificate, it is not permissible to submit multiple versions to demonstrate a complete set of capability. It is possible for signatories to use evidence from witnesses for capabilities that they have not personally observed. Signatories may receive alternative evidence they know to be reliable from a colleague (if the colleague is a trainee, they must be working satisfactorily as a senior trainee).

Completed by supervisor

You must have it completed by either:

  • a consultant in a physicianly specialty (a full list can be found on the JRCPTB website) or

  • a consultant in an alternative specialty, eg emergency medicine or intensive care medicine, who holds the MRCP(UK) diploma, or is a fellow of one of the three royal colleges of physicians of the United Kingdom

You must have worked with them:

  • in a medical specialty, emergency medicine or intensive care medicine post

  • for a minimum continuous period of three months since 1 January 2019.

Evidence of signatory's professional registration

It is your responsibility to provide adequate evidence of the professional status of any signatory who is not registered with the GMC.  

This evidence must be scanned and attached with the alternative certificate. Where this evidence is not in English, an official English translation should also be provided. In cases where the signatory has historic but not current GMC registration, it is the current registration that is required; previous GMC registration will not be accepted. Where adequate evidence is not provided, you will be unable to progress to the next stage of the recruitment process.

Notes about the certificate

Below are some notes answering common questions about the criteria for completing the certificate:

  • The three months is whole-time equivalent and could be spread out over a period much longer than this; for example, if you are doing research but have been undertaking clinics during this time to maintain your clinical skills, the three months may be spread over the three-year period.

  • You do not need to have practised all capabilities within the three-year period but whoever is signing the form needs to be satisfied that there is no reason why these competences are in doubt and that they believe you are sufficiently capable to progress to HST. Examples of how supervisors can be satisfied with your capability include:

    • first-hand knowledge via supervision of you

    • discussion with previous clinical supervisors
    • (for those maintaining one) viewing your ePortfolio.
  • It is permissible for a supervisor to sign off capabilities which they have not personally witnessed, provided they have the satisfactory assurance that competence has been gained.  

Candidates previously undertaking CMT/ACCS-AM/IMT

If you have previously undertaken an IMT, CMT or ACCS-AM programme and did not have one or more competences signed off on your ePortfolio, it is not permissible for this to be signed off on your alternative certificate on the basis of being acquired during the programme.

Instead your supervisor will need to be satisfied that any competences which are not recorded as complete in the ePortfolio have been achieved and demonstrated subsequent to leaving the core programme.

Candidates applying to HST from 'non-physicianly' training routes

In addition to applicants whose experience to date has been in 'physicianly' medicine, several specialties participating in the recruitment process also allow applications from trainees from other specialty pathways.

These specialties are: allergyaudiovestibular medicine, clinical genetics, clinical neurophysiology, dermatology, haematology, immunology, medical opthalmology, rehabilitation medicine and sport & exercise medicine.

For these specialties the competence requirements can vary slightly depending on the training backgrounds they seek. You are advised to review the relevant person specifications as their requirements are outlined within.

Demonstrating capability

Regardless of the specialty in which you have trained, unless you are a current UK trainee on track to gain all required capabilities, you will need to attach evidence to your application form.

If you are applying to a specialty which accepts trainees from another specialty pathway, and you have trained outside of a UK training programme in that specialty, the way in which you can demonstrate competence differs depending on the specialty of your training and you should check the relevant person specification.

Alternative certificates

A number of specialties have specific alternative certificates which should be used to demonstrate competence gained in these programmes. These forms are usually available from the Oriel Resource Bank; if you cannot locate this, please contact the relevant royal college or lead recruiter for that specialty pathway.

In most cases, applications made without evidence of core capability, other than those currently in pre-HST UK training, will not be eligible and their application will be rejected.

However, it is recognised some doctors have exceptional circumstances, such as refugees, and may not be able to provide an alternative certificate at time of application. 

Applicants in this position will have the opportunity on the application form to explain their circumstances and, subject to approval, may be given more time to submit a certificate. Although candidates with exceptional circumstances can be initially considered without an alternative certificate, this will be required before being able to take up an offer of a programme.

Candidates who think they may have exceptional circumstances should contact their local postgraduate region for further advice - please refer to the region contacts page of this website. Where possible, regions will be able to provide assistance for bona fide refugee doctors in obtaining an alternative certificate.

Unless you are a current pre-HST UK trainee, or have exceptional circumstances, you will be required to upload/attach evidence of your achievement of core capabilities to your application form. 

Evidence must be uploaded where necessary

If you are required to supply evidence but submit your application without it, it is likely that your application will be rejected as ineligible. Therefore, please ensure you have this ready to attach to your application prior to submission.

If your status requires evidence to be supplied at the time of application, the application form prompts you into attaching this and will not let you submit without. It is not permissible to claim you have exceptional circumstances and submit without evidence unless your circumstances warrant this.

Uploading/attaching documentation

Where required to provide evidence with your application, an electronic version must be uploaded to your application form when prompted.  

There are two ways of doing this. You can either do it by uploading the correct documentation during the application process, or you can upload documents to your document library/repository on Oriel. The link to do this is on your Oriel dashboard. 

Please ensure you select the correct document category, only categories which match the options you choose in the form can be attached to your application. 

The maximum size of an upload is 10MB. However, if the document you wish to upload is bigger than 10MB, you can divide and upload this as multiple files.

In the event you encounter any difficulties with uploading or obtaining a document - please submit a query via the candidate enquiries portal.