Training in an infection specialty is particularly interesting and varied because it combines both the clinical and laboratory skills of making diagnoses with the satisfaction of effective treatment for a wide range of common serious infections in both acutely and chronically ill patients.

There are four separate infection specialties: infectious diseases (ID), medical microbiology (MM), medical virology (MV) and tropical medicine (TM). To find out more about each of the specialties click on the pop-out boxes below.



Combined infection training (CIT)

The first two years, have a common combined infection training programme in all four specialties. After the two Combined Infection Training years the four specialties have their own separate higher specialty training programmes leading to a CCT in that particular specialty.

All four specialty training programmes include both clinical management of patients with infections and laboratory diagnostic experience. Most trainees undertake research leading to an MD or PhD degree at some point in training.

Infection training - trainee characteristics

Infection specialties will particularly suit trainees who enjoy:

  • a great variety of clinical presentations

  • the challenge of making the correct diagnosis

  • laboratory sciences.


Group 1 and Group 2 programmes

Recruitment to combined infection training programmes will be at ST4 and ST3 level, which means it contains both Group 1 and Group 2 specialty programmes. The 'Planning your application' tab has more information about how this affects applications to combined infection training as there are key differences compared to most specialties.

Joint specialty training

It's possible for two CCTs to be obtained as well as one CCT in an individual infection specialty. Joint programmes are available in a number of combinations and will require additional training time.

Initially, applcants will be in competition for all available posts across the infection specialties in the Group(s) to which they have applied. They will be able to preference their preferred CCT single specialty or joint specialties during the recruitment process. The available programme combinations are as follows:

Group 1

  • Infectious diseases and general internal medicine
  • Tropical medicine and general internal medicine

Group 2

  • Infectious diseases and medical microbiology
  • Infectious diseases and medical virology
  • Medical microbiology
  • Medical virology
  • Tropical medicine and medical microbiology
  • Tropical medicine and medical virology

Working/training in an infection specialty training post

Training in the infection specialties is particularly interesting and unlike many medical specialties infection specialties are not confined to a single organ or system. Infections can present in many different ways, in patients of all ages and backgrounds. Combined infection training offers a broad training in the diversity of infection diagnosis and management in a range of clinical settings, both outside and inside the infectious diseases unit, and includes time learning laboratory skills and antimicrobial and infection control management.

Diagnostical skill

Making the correct diagnosis often involves considerable detective skill in history-taking, physical examination and interpretation of laboratory data.

Treating serious infections in acutely ill patients is very satisfying, because the vast majority of patients make an excellent recovery, and this is increasingly true for many patients with chronic infections.

Before entering higher specialty training, core experience in a broad range of specialties is desirable; prior experience of any of the infection specialties is useful but not essential.

Career prospects

Many infection specialty consultants work in teaching hospitals with access to specialised investigations and many pursue research interests.

The increasing number of infection related consultant posts is evidence of the wider recognition of the distinctive clinical value of the various infection disciplines.

Given the growing numbers of patients with HIV and tuberculosis, the widespread use of immuno-suppressive treatments, increasing transplantation numbers, breakthroughs in hepatitis management, and the importance of healthcare-associated infections and management of antimicrobial prescribing, there has never been a better time to become an infection specialist. Changes in laboratory practice have meant that medical virologists and microbiologists not only have access to increasingly sophisticated diagnostics but also have clinical roles alongside infectious diseases and tropical medicine colleagues.


Medical Care

Find out more about combined infection training 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 combined infection training is Thames Valley.

Health Education Thames Valley
General queries [email protected]
Website https://thamesvalley.hee.nhs.uk/medicine/

 

Group 1 and Group 2 programmes included

Recruitment to combined infection training programmes will be at ST4 and ST3 level, which means it contains both Group 1 and Group 2 specialty programmes. Those wishing to apply need to be aware of how this impacts the process and what you will need to do, as there are key differences compared to most specialties.

  • Group 1 – this includes infectious diseases, and tropical medicine where available, programmes which are dual accredited with general internal medicine. It is not possible to single accredit in infectious diseases and tropical medicine.
  • Group 2 – this includes:
    • Single accredited programmes in medical microbiology or medical virology
    • Infectious diseases or tropical medicine programmes which are dual accredited with either medical microbiology or medical virology.

Two vacancies/applications, one interview

There will be two combined infection training vacancies, one at ST3 and one at ST4. If you are eligible, and wish to be considered, for both ST3 and ST4 programmes, you will need to submit two applications – one to each vacancy. Those applying to, and eligible for, both vacancies will undergo a single interview, with scores used for both vacancies; more detail is included further down the page and on the ‘Interview & scoring’ tab in this section.


Eligibility

Combined infection training only accepts candidates from physician training routes. However, Group 1 and Group 2 specialties have differing entry requirements:

  •  Group 1 – eligibility requires completion of the internal medicine training (IMT) stage 1 programme or equivalent.
  • Group 2 – eligibility requires completion of the first two years of the internal medicine training (IMT) stage 1 programme or equivalent.

 If you are eligible for Group 1 programmes, you will, by default, be eligible for Group 2. Please visit the am I eligible? section of this website for further information about the eligibility criteria for both Group 1 and Group 2 specialties.


Commitment to specialty

Combined infection training will be assessing your commitment to specialty as part of the shortlisting process. This will be looking at your commitment to infection training and will be scored based on your activity and interest across any of the specialties included in the combined infection training programme. Please visit the application scoring page for general information about how this is assessed and scored.


How applying to both vacancies will work

The information below is advice for those planning to apply to both vacancies.

Applying

The two vacancies will have identical application forms and it will be necessary to duplicate the information across both. If you completely submit one application before starting the other, you will be given opportunity to request some sections of the form are copied over but will have to manually copy over the ‘Evidence’ and ‘Supporting’ sections. There is no need to tailor the application form for the two different vacancies and you should directly copy between the two.

Evidence verification and shortlisting

Your application will be assessed once, with scores copied to both vacancies. We anticipate you will only need to upload evidence once but this is not confirmed at time of writing. Shortlisting will either be for both vacancies or neither, you will not be shortlisted for one and not the other.

Invitations to interview

You will be asked to book onto one interview, which will be through one of the two vacancies; the lead region will confirm which when you are invited. Once booked, they will manually book you onto the other vacancy to enable your application to progress through the system. It is imperative that you do not book onto two separate interviews across the two vacancies.  

Interview and ranking

You will attend a single interview with an additional Group 1 specialty question at the end of the interview for those in contention for both vacancies. You could be found appointable for Group 2 and not Group 1 if your performance in the additional question takes you below the appointability line. As all the Group 2 assessment is within the Group 1 assessment, you cannot be appointable for Group 1 and not appointable for Group 2.

The scores will be duplicated across both vacancies, with the additional question scores added on to make the Group 1 application. This means you will get two independent final assessment scores and rankings, ranked against the other applicants within each vacancy.

The ‘Interview & scoring’ gives further details on these areas.

Preferences and offers

You will need to separately preference the programmes within each vacancy as there will be a separate offers process for Group 1 and Group 2 so, depending on your rank and preferences, you may receive two offers. You can hold one whilst awaiting the outcome of the other, as per the normal offer rules.

 

 

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 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 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

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.

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)
East Midlands

2 (ID/MM)

1 (MV)

1 (ID/MV)

N/A

12/01/2022 - 01/02/2022

30/03/2022, 31/03/2022

East of England

0 - 2

0 - 1 (ID/MM)

0 - 1 (MM)

0 - 1(MV)

(ID/GIM)

N/A

London and KSS

Kent, Surrey & Sussex

0

N/A

 London 

8 - 10

N/A

North East

2 (MM)

1 (ID/MM)

N/A

North West 

Mersey

0 - 2 (ID/MM)

N/A

North Western

0 - 1 (ID/MM)

N/A

South West

Peninsula

0 - 1 (MM)

N/A

Severn

0 - 1 (ID/GIM)

0 - 1 ID/MM)

N/A

Thames Valley

0 - 1 (ID/MM)

N/A

Wessex

0 - 1 (ID/MM)

N/A

West Midlands

0 - 1 (ID/MV)

0 - 4 (ID/MM)

0 - 2 (ID/GIM)

N/A

Yorkshire & Humber

1 (MM)

1 (ID/MM)

N/A

Scotland**

3 (ID/MM)

2 (ID/GIM)

2 (TBC)

TBC

Wales

0 - 1 (ID/MM)

TBC

**Specialty combinations are listed in brackets where known.

*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

There is a slightly different interview depending on whether you are in contention for Group 1 programmes or just Group 2. The majority of the interview will be the same, with an additional question at the end for those in contention for Group 2 programmes. There are four questions for Group 2 candidates in this interview, and the additional 'Medical registrar readiness' question for Group 1 candidates, ranging between 5-8 minutes in length. The interview overall will be approximately 35 minutes long with an additional five minutes for Group 1 candidates. 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

The appointability requirements differ slightly for the Group 1 and Group 2 assessments. 

Group 1

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.

Group 2

Raw interview score

The RIS is the sum of all eight 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 8 and 40.

Appointability requirements

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

  • none of your eight interview scores can be 1/5
  • no more than two of your eight interview scores can be 2/5
  • your RIS must be 24 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 accessible through the link below:

    

 

  

    

 Interviewer   1

  

    

 Interviewer   2

  

    

Weighting

  

    

Max score

  

Question 1

Presentation

/ 5

/ 5

1.8

18

Question 2

Suitability & commitment

/ 5

/ 5

2.5

25

Question 3

Clinical scenario

/ 5

/ 5

2.5

25

Question 4

 

Quality improvement

/ 5

/ 5

1.2

12

Question 5 (Group 1 only)

Medical registrar suitability / 5 / 5 1 10
 Application score / 58 0.35 / 20.3
Group 1 Group 2
Raw interview score / 50 / 40

Interview score (w weighting)

/ 90

/ 80

 Total score

/110.3

/ 100.3