Acute internal medicine (AIM) is an exciting, varied, and dynamic medical specialty, concerned with the assessment, diagnosis and management of adults presenting to secondary care with acute medical illness.

It also entails the management of busy acute medical units (AMUs) to ensure that they deliver high-quality, efficient and patient-centred care.


AIM trainee characteristics

Trainees in AIM need particularly:

  • good team-player skills, including clinical leadership and change-management skills

  • flexibility, adaptability and lateral thinking skills

  • excellent communication skills, both spoken and written

  • the ability to work (and enjoy working) under pressure.


Working in AIM

This is a hospital-based specialty, with the majority of the work involving care of medical patients around the time of admission to hospital. The spectrum of clinical problems encountered in the AMU is very wide, and this variability enables trainees to become experts in assessment, investigation, diagnosis and management across multiple disciplines.

Training

Training concentrates not only on recognition and management of acute medical emergencies, but also on the development of ambulatory care systems, and the acquisition of skills in leadership and management of AMU as a whole.

There is also a requirement to develop an additional specialist skill (usually in the form of either a professional qualification, a procedural skill, or a research degree. Common examples include diplomas in medical education or toxicology and practical skills such as bed side echo). There are also options to extend training and gain extra qualifications in stroke/critical care to CCT level.

Training includes time on AMU with a focus on managerial AMU experience towards the end of higher specialist training. There are also mandatory attachments in respiratory medicine, cardiology, acute elderly care and intensive care. Rotations may also include others such as gastroenterology/neurology/stroke but this varies from region to region.

Focus on medical problems and ongoing care

The specialty is distinct from emergency medicine (ED), because it focuses specifically on medical problems and includes more responsibility for ongoing care - although acute physicians do work in close collaboration with emergency medicine specialists. There is also a close relationship with critical care and most specialities will offer degrees of in-reach into the AMU.

Medical Care

Find out more about acute internal medicine and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.


Further information

General / application queries

For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Physician Specialty Recruitment Office.

Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for acute internal medicine in is West Midlands. 

Health Education West Midlands
Postal address Health Education West Midlands
1st Floor
St Chads Court
213 Hagley Road
Edgbaston
Birmingham
B16 9RG
Email address [email protected]
Website www.westmidlandsdeanery.nhs.uk

Group 1 specialty

This is a Group 1 specialty and requires completion of the internal medicine training (IMT) stage 1 programme or equivalent; all programmes in the specialty will dual specialise with general internal medicine. 

Therefore, this specialty uses the standard HST eligibility criteria for Group 1 specialties and does not accept candidates from any alternative training routes. Please visit the am I eligible? section of this website for further information.

Commitment to specialty

The specialty will be assessing your commitment to specialty as part of the shortlisting process. Please visit the application scoring page for more information about how this is assessed and scored.

ICM applicants seeking to dual train

Although the specialty usually only accepts trainees who have completed the full Internal Medicine Stage 1 Training curriculum requirements, an exception is for current intensive care medicine trainees who are applying with the intention to dual train in this specialty. These trainees can be considered provided that they can demonstrate all of the following:

  • Completion of UK Core Medical Training or ACCS acute medicine; they do not apply to IMT trainees who left the programme early, before completing the full curriculum outcomes.
  • Successful completion of ST3 in ICM by the advertised post start date.
  • Making satisfactory progress with their ICM training, evidenced by ARCP.
  • In addition, applicants must not be beyond the end of ST5 in ICM at the time of interview if they are applying with the intention of undertaking a dual CCT programme with ICM.

 It will be necessary to complete the Internal Medicine Stage 1 curriculum as part of the higher specialty training programme and this will be reviewed with your training programme director, taking into account your individual circumstances.

 These are transitional arrangements which will be in place for 2022 recruitment. It is not guaranteed that this will extend to future years at time of writing.

Indicative post numbers

Indicative vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts. In many cases these will be presented as a range (e.g. 1-4) as it is not always possible for regions to know at this stage how many vacancies there will be.

It is the intention that indicative post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Please note that this table is not likely to be updated subsequent to indicative numbers and actual numbers will be confirmed when programme preferences are opened later in the round.

Numbers subject to change

Please be aware that it is not uncommon for vacancy numbers to change as the round progresses.

More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. In the past, post numbers have risen an average of 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.

It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.

Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.

 

Round 1 Interview dates & posts

Region NTN posts LAT posts* Evidence upload date(s)Interview date(s)
HE East Midlands n/a

13/12/2021 - 22/12/2021

5,6,7 April 2022

HE East of England 4 - 8 n/a

London and KSS

London
5 - 11

KSS

1 - 4

 n/a
 n/a
HE North East 1 - 4 n/a
HE North West

Mersey

 3 - 3

n/a

North Western

3 - 3

n/a
HE South West

Peninsula

0 - 1

n/a

Severn

0 - 4

n/a
HE Thames Valley 0 - 1 n/a
HE Wessex 2 - 4 n/a
HE West Midlands 0 - 1 n/a
HE Yorkshire & Humber

0 - 8

n/a
Scotland** 0 - 6 TBC
Wales 0 - 2 0 - 2

*English LATs

Please note, English regions do not recruit to LAT posts.

**Scotland post numbers

If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish regions is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.

The SMT website will always be the more accurate one where they differ.

Interview content

The interview will consist of four questions which range between 5-10 minutes in length. You will be marked on these four questions and your communication skills, giving five scored areas in total. You will be scored by two interviewers on each question.

Including time for questioning and scenario reading, the interview will be approximately 25-30 minutes.

Please note that this is subject to change and will be confirmed by the date of interview.

Scoring framework

The score of 1-5 an interviewer will award you for each assessment area is judged in relation to how well you perform against an expected level. Below is the framework used to award scores at interview, as well as interpretation of what these scores represent:

  

  

  

Mark

  

  

  
  

  

  

 Rating

  

  

  
  

  

  

Assessment

  

  

  

1

poor

not considered appointable

2

area for concern

performed below the level expected from a core level trainee applying to the specialty;
possibly unappointable, subject to discussion and performance in other areas

3

satisfactory

performed at the level expected of a core level trainee applying to the specialty;
the candidate is suitable for a higher specialty training post

4

good

above average ability;
the candidate is suitable for a higher specialty training post

5

excellent

highly performing trainee;
the candidate is suitable for a higher specialty training post

As shown in the table, for each of the question areas at interview, 3/5 is considered a satisfactory score; and reflects the level of performance that would be expected of a trainee ready to progress to a specialty training programme.

Should your performance go above and beyond this expected level, interviewers can award marks of 4/5 or 5/5 as appropriate.

Conversely, should your interview performance not reach the expected level, then interviewers can award marks of 1/5 or 2/5, as reflects their level of concern over your performance.


Appointability

Raw interview score

The RIS is the sum of all ten scores awarded to you during your interview, but before any weighting is applied.

As each individual score will be between 1 and 5, your RIS will be between 10 and 50.

Appointability requirements

To be classed as 'appointable', you must meet all three criteria below:

  • none of your ten interview scores can be 1/5
  • no more than two of your ten interview scores can be 2/5
  • your RIS must be 30 or above.

If you meet all three requirements, your application will be assessed as appointable, and can progress to be considered for offers.

However, if you fail to meet any of these requirements, your application must then be assessed as not appointable, and it will progress no further in that round.


Total Score

After interview, a weighting is applied to the scores in each area, as well as your application score.

These scores are then combined to give your total score which determines your ranking, which will in turn be used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, is detailed in the table accessible through the link below:

    
 
  
    
 Interviewer 1
  
    
 Interviewer 2
  
    
Weighting
  
    
Max score
  
Question 1
Clinical scenario
/ 5
/ 5
2.5
25
Communication
/ 5
/ 5
1.2
12
Question 2
Medical registrar suitability
/ 5 / 5 1.0 10
Question 3
Application & training
/ 5
/ 5
2.5
25
Question 4
 
 
 
Suitability & commitment
/ 5
/ 5
1.8
18
Raw interview score
/ 50
Interview score (w weighting)
/ 90
 Application score
/ 58
0.35
/ 20.3
 Total score
/ 110.3

As part of the process of applying to HST, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.

To this end, we have published data dating back to 2013 (where this is available), based around four main areas:

  • Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.

  • Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.

  • Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.

  • Post fill rates - the number of posts filled by region. 

We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.

Please note that due to the ongoing COVID-19 situation, certain recruitment processes have been affected for round 2 ST3 PSRO-coordinated specialties. As a result, the below information on this page is not applicable for this round only and should not be used where the process has changed. Please refer to the applicant guide for the latest information about how round 2 will operate.

Further guidance about the scoring format of interviews will be published to each specialty page and we hope to have this updated by application closing date. Please visit the specialty pages closer to the time for updated information.

 

Interview content

#You will spend approximately 10-15 minutes at station 1 and 10 minutes at station 2 and 3, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 50-55 minutes.

Click on the relevant stations below for more information on the content of the interview.

Please note that this is subject to change, and will be confirmed by the date of interview.


Interview scoring

Appointable - automatic

If you are awarded a score of at least 3/5, for all marks given to you at your interview, then you will automatically be classed as appointable.

Not appointable - automatic

If any of the 12 scores awarded to you at interview are 1/5, this will reflect poor performance and an area of major concern.

If four or more of your 12 interview scores are of 2/5, this will reflect several areas of concern across your whole interview.

Should your interview assessment fall under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable.

Appointability subject to panel decision

In the event that your 12 interview scores contain one, two or three marks of 2/5 (and the rest 3/5 or above), your appointability status will be subject to discussion in the post-interview 'wash-up' meeting.

The clinicians who have interviewed you will discuss your general performance during the interview and any concerns or otherwise they have about your application as a whole.

Should they deem it appropriate, your application will be classed as appointable, and you can then be considered for post offers; whereas if they feel their concerns are too substantial for this outcome, they must class your application as not appointable, and it will progress no further in the current recruitment round.

Review vs automatic status

Please note there is no distinction made between candidates judged as appointable automatically, and those classed as appointable on review. Once deemed appointable it is only your overall score which will be used to determine ranking.

Total score calculation

After interview, a weighting is applied to the scores in each area, as well as the application form score, to give a 'total score'. This score determines your ranking which is used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.

Please note that this is subject to change, and will be confirmed by the date of interview.

date of last review: 6 December 2019