In most cases you do not apply directly to general internal medicine (GIM) at ST4 level. Training in GIM will be done in parallel with training in one of the Group 1 physician specialties and access to ST4 training is gained by applying for one of these specialty programmes. Group 1 programmes offer dual accreditation in the specialty and GIM.
The Group 1 programmes which dual accredit with GIM are acute internal medicine, cardiology, clinical pharmacology and therapeutics, endocrinology and diabetes, gastroenterology, geriatric medcine, genitourinary medicine, infectious diseases, neurology, palliative medcine, renal medicine, respiratory medicine and rheumatology.
However, there are two additional routes to training in GIM: single accredited GIM, and single accredited GIM with stroke medicine sub-specialisation.
If you are interested in applying for this programme, search under 'Stroke Medicine / General Internal Medicine' in the vacancies page on Oriel.
Single accredited GIM with sub-specialty stroke medicine recruitment
A pilot programme for single accreditation in general internal medicine coupled to sub-specialty stroke medicine is starting in 2024. Training comprises two years of GIM and a year of stroke medicine. This would mean successful applicants could go from completion of Internal Medicine Stage 1 to completing training (CCT) after a further three years of training. They could be completed in any order but it is most likely that the middle or final year would be stroke medicine. Recruitment to these programmes will start in the second round of 2024 recruitment and the other tabs in this page of the website relate to the application and interview process. This specialty will follow the same timetable as other HST specialties.
The specialty
The current GIM curriculum is designed to provide broad training in the key skills which will be required by consultants taking part in the admission and inpatient management of patients with acute medical problems as well as patients with chronic medical conditions. The curriculum builds on IMT to allow the trainee to perfect their skills in GIM.
There is a growing demand for high quality GIM skills as the UK population ages and patients develop multiple, complex co-morbidities. Delivering good GIM care will become a rewarding part of physician practice.
GIM and Stroke medicine combine very well together. This training scheme will allow you to use all your GIM skills coupled to training in managing patients along the whole stroke pathway: from hyperacute treatment through post-acute, detailed ward management to rehabilitation and discharge. There will also be opportunities to consult in out-patients and become involved with national stroke audit and research.
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 this specialty is Thames Valley.
| NHS England Thames Valley | |
| Email address | [email protected] |
| Wesbite | https://thamesvalley.hee.nhs.uk/medicine/ |
Group 1 specialty
This is a Group 1 specialty and requires completion of the internal medicine training (IMT) stage 1 programme or equivalent.
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.
If you are interested in applying for this programme, search under 'Stroke Medicine / General Internal Medicine' in the vacancies page on Oriel.
Commitment to specialty
The specialty will not be assessing your commitment to specialty as part of the shortlisting process and will score your application purely via the self-assessment scoring framework. Commitment to specialty will be assessed as part of the interview.
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.
R1 Interview dates and posts
| Region | NTN posts | Evidence upload date(s) | Interview date(s) |
| East Midlands | TBC |
6 - 15 January 2025 |
01, 02 April 2025
|
| East of England | 0 - 6 | ||
| London | TBC | ||
| Kent, Surrey and Sussex | TBC | ||
| North East | 0 | ||
| North West | 0 - 1 | ||
| South West |
Severn 0 - 2 Peninsula 0 - 2 |
||
| Thames Valley | 0 - 1 | ||
| Wessex | 0 - 2 | ||
| West Midlands | 0 - 1 | ||
| Yorkshire and Humber | TBC |
Interview Content
The interview be split across two separate stations with a separate pair of interviewers scoring you on the areas within their station. There will be four questions 7.5 minutes in length. You will be marked on these questions with five scored areas in total; one question generating two separate marks and a communication mark applied based on one of the stations. The headings below show the question areas and in which station they will be covered, along with information about what will be assessed.
Each station will last 15 minutes, so including the time between stations, the interview will be approximately 35 - 40 minutes.
Please note that this is subject to change and will be confirmed by the date of interview.
At the start of this question you will read a clinical situation to consider. Interviewers will provide you with some information about a patient to ask for your initial response and will follow this up with a series of follow-on probes relating to the diagnosis and management of this case. This question will last approximately 7.5 minutes.
Clinical scenario considerations
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved. Some points to consider when reviewing the scenario and preparing for discussion are:
- what steps you would take
- any potential treatments possible
- any further information you would gather
- how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario
You should also consider any other factors you deem appropriate, using your experience and professional judgement.
This question will explore the non-clinical aspects of being a medical registrar, focusing on two of the Capabilities in Practice (CiPs) from the Internal Medicine Stage 1 Curriculum:
- Managing an acute unselected take
- Managing a multi-disciplinary team including effective discharge planning
You are required to start the station with a one-minute presentation: ‘A summary of your experience managing the acute unselected medical take as the medical registrar.’ In describing your experience, your presentation should summarise the following:
- The roles and duration you have undertaken in this capacity
- The level of responsibility you have held, and the degree to which you have been supervised
- The size and profile of the multi-disciplinary teams you have managed
- The number of patients for which you were directly and indirectly responsible whilst leading the acute unselected medical take
- Outline of the non-clinical duties you have performed in the role.
Following your presentation, interviewers may ask questions to clarify or ask you to expand upon your experience.
The remaining time in the station will ask you to draw on your experience of managing a team caring for acute medical admissions by giving examples of how you have managed different situations.
This question will last approximately 7.5 minutes.
Presentation guidance
When preparing your presentation, please bear in mind the points below:
- Give headlines and brief descriptions to maximise the time available.
- Ensure your presentation is clear and well-structured.
- One-minute time limit - Your presentation must last for no more than one minute, and you will be stopped at this point.
- No aids/resources allowed – you are not allowed to use any visual representations, such as PowerPoint, when giving your presentation and you must not share your screen. You are welcome to use notes, but these should be for your own use only.
Not an actual question, you will be assessed and scored specifically on the communication skills you demonstrate throughout the station.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers throughout all questions.
This question will explore ethical, professionalism and governance issues. It will start with a hypothetical situation which is not given to you before entering the station and will be given verbally by interviewers.
This is not a clinical question, but will deal with the moral, ethical, legal, etc. issues of a particular situation. Following the hypothetical situation, and where time allows, there will be one or more questions about GMC Good Medical Practice principles.
The assessment of this question is underpinned by the principles of GMC Good Medical Practice.
This question will last approximately 7.5 minutes.
This question will see you scored on two areas via a combined question which covers both elements:
- Application form and training to date - questions based on your career, achievements to date and your engagement with training and learning
- Suitability and commitment - looking at your suitability and commitment to training in the specialty, giving you opportunity to expand on the information provided in your application form
It is important to recognise that the application form and training scores awarded to you will not purely be about your achievements, as this already contributes towards the scoring via your application form. Interviewers will be deciding upon scores via a combination of factors, for example: your responses to the questions asked, the breadth and quality of your achievements and your career progression.
This question will take approximately 7.5 minutes.
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; |
|
3 |
satisfactory |
performed at the level expected of a core level trainee applying to the specialty; |
|
4 |
good |
above average ability; |
|
5 |
excellent |
highly performing trainee; |
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 (RIS)
The RIS is the sum of all twelve 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 12 and 60.
Appointability requirements
To be classed as 'appointable', you must meet all three criteria below:
- none of your twelve interview scores can be 1/5
- no more than two of your twelve interview scores can be 2/5
- your RIS must be 36 or above.
If you meet all three requirements, your application will be assessed as appointable, and can progress to be considered for post 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 below:
|
|
Interviewer 1
|
Interviewer 2
|
Weighting
|
Max score
|
|
Station 1 - Question 1 |
||||
|
Clinical scenario |
/ 5 |
/ 5 |
1.6 |
16 |
|
Station 1 - Question 2 |
||||
|
Medical registrar suitability |
/ 5 |
/ 5 |
1.6 |
16 |
|
Station 1 - Question 3 |
||||
|
Communication mark |
/ 5 |
/ 5 |
0.8 |
8 |
|
Station 2 - Question 1 |
||||
|
Professionalism, governance and ethics |
/ 5 | / 5 | 1.6 | 16 |
|
Station 2 - Question 2 |
||||
|
Application & training |
/ 5 | / 5 | 1.2 | 12 |
|
Station 2 - Question 3 |
||||
|
Suitability and commitment |
/ 5 | / 5 | 1.2 | 12 |
|
Raw interview score |
/ 50 |
|||
|
Interview score (w weighting) |
/ 80 |
|||
|
Application score |
/ 40 |
0.5 |
/ 20 |
|
|
Total score |
/ 100 |
|||
As there is no historic data for this specialty, this page will be populated when the recruitment round has ended.
