If delivering high-quality, patient-centred care is up your street, then palliative medicine could be the specialty for you.
Its rewards are endless, which shouldn't be surprising given that its hallmark is holistic care of the highest possible standard.
Palliative medicine - trainee characteristics
Those entering the specialty should:
-
be skilled communicators, with the desire to improve yet further
-
bring enthusiasm and dynamism to multidisciplinary team-working
-
have an interest in ethical issues and a commitment to finding the best way forward when challenges arise
-
enjoy complex decision-making, often as part of a team, and always in conjunction with patients and families.
Working in a Palliative Medicine specialist training programme
Unique training
Palliative medicine specialist training is like no other. You will learn to care for patients with a great range of illnesses, of all ages and in all settings. Contrary to misconceptions, it is about enabling patients and families to make the most of living, through expert, holistic treatment and care, and has a reach far beyond the care of the dying patient. You will strive to provide optimum symptom control, psychological support and practical assistance to those with a wide range of life-limiting conditions.
Your training will take you into multiple settings, including patients' own homes, emergency departments, hospices, acute hospital wards, specialist hospital units (e.g. oncology, renal), and more. This breadth of experience is key; as a consultant you may work as part of a hospital, hospice or community palliative care team, or often a combination.
Specialty evolution
Palliative Medicine's evidence base is evolving at a great rate, although it will never be a protocol-driven specialty. It requires you to think on your feet, and to use empathy and pragmatism, as well as science, to make the right clinical decisions.
Since 2022 Palliative Medicine is a group 1 specialty, with doctors dual accrediting with Internal Medicine (IM). Applicants must therefore have evidence of achievement of stage 1 IM capabilities through an accredited training programme or Alternative Certificate.
The four-year training will now offer even more variety, with posts in hospital medicine and hospital palliative care teams, contrasting with those in hospices and community palliative care teams. To achieve the curriculum requirements, you will complete a maximum of 12-months in relevant Internal Medicine posts (e.g. Geriatric Medicine), including participation in acute unselected take, with the IM training delivered in three-to-six-month blocks throughout training, depending on local arrangements. The majority of training will continue to be delivered in Palliative Medicine posts, where you can develop as a Palliative Medicine specialist, whilst applying your general medical knowledge.
In the future we anticipate there will be a wide range of consultant opportunities, working in hospital, hospice and community. Some consultant posts may have an IM component, but it is not anticipated that this will be the case for all posts.
There are also numerous opportunities alongside your clinical training to participate in education, research and service development. You will be supported to take time out of programme to develop special interests if this is what you want to do.
Rewarding
Palliative Medicine is, without doubt, a challenging field in which to work. The potential for improving patients' and families' quality of life is vast, making the specialty uniquely rewarding. Hence all applications are encouraged.
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 palliative medicine is West Midlands.
NHS England West Midlands | |
---|---|
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.
This specialty does not require you to load documentary evidence to demonstrate your commitment; this will be assessed via your application form.
Expected to participate in round 2
This specialty has traditionally particpated in the second round. Although it cannot be guaranteed until the first round is completed, it is very likely that there will be a second round for this specialty this recruitment year. Participation in the second round is confirmed in June each year.
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
|
1 - 3 | N/A |
20/12/24 - 03/01/25
|
25, 26, 27 March 2025 |
East of England
|
10 - 12 | N/A | ||
London
|
5 - 11 | N/A | ||
Kent, Surrey and Sussex
|
0 | N/A | ||
North East
|
TBC | N/A | ||
North West
|
Mersey TBC North West TBC |
N/A | ||
South West
|
Peninsula
0 - 2
|
N/A | ||
Severn
1 - 2
|
N/A | |||
Thames Valley
|
TBC | N/A | ||
Wessex
|
TBC | N/A | ||
West Midlands
|
TBC | N/A | ||
Yorkshire & Humber
|
TBC | N/A | ||
Scotland**
|
2 - 5 |
TBC
|
||
Wales
|
1 - 2 |
TBC
|
||
Northern Ireland
|
TBC | TBC |
*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.
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:
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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.
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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.
Round 1
Year | Apps. | NTN posts | LAT posts | Total posts | Comp. | Unique* |
---|---|---|---|---|---|---|
2024 | 101 | 64 | 1 | 65 | 1.5 | TBC |
2023 | 69 | 59 | 1 | 60 | 1.2 | 55% |
2022 | 53 | 50 | 1 | 51 | 1 | 30% |
2021 | 66 | 27 | 2 | 29 | 2.3 | N/A** |
2020 | 137 | 46 | 2 | 48 | 2.9 | 71% |
2019 | 91 | 22 | 2 | 24 | 3.8 | 73% |
2018 | 106 | 37 | 1 | 38 | 2.8 | 71% |
2017 | 99 | 25 | 4 | 29 | 3.4 | 78% |
2016 | 126 | 39 | 1 | 40 | 3.2 | 68% |
2015 | 124 | 31 | 9 | 40 | 3.1 | 73% |
* the percentage of unique candidates that only applied to this specialty (out of the PSRO-coordinated specialties)
** As many specialties did not participate in recruitment in 2021, the data is not comparable.
Round 2
Year | Apps. | NTN posts | LAT posts | Total posts | Comp. |
---|---|---|---|---|---|
2023 | 25 | 35 | 1 | 36 | 0.7 |
2022 | 11 | 38 | 1 | 39 | 0.3 |
2021 | 37 | 16 | 0 | 16 | 2.3 |
2020 | 59 | 15 | 1 | 16 | 3.7 |
2019 | 36 | 17 | 1 | 18 | 2 |
2018 | 26 | 12 | 0 | 12 | 2.2 |
2017 | 31 | 15 | 1 | 16 | 1.9 |
2016 | 22 | 6 | 1 | 7 | 3.1 |
2015 | 35 | 11 | 6 | 17 | 2.1 |
Interview content
The interview will 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 between 5 - 8 minutes in length, with the ethical scenario split into two distinct areas to give five scoring areas in total. 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 40 minutes.
Please note that this is subject to change and will be confirmed by the date of interview.
This question will focus on your suitability for and commitment to training in the specialty and give you opportunity to expand on the information provided in your application form.
This question will last approximately 7 minutes.
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 8 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.
In this question you will be awarded one mark based on your approach and skills in handling an ethical scenario and a separate mark for your communication and reflection skills.
Ethical scenario
This takes the form of a hypothetical situation, described briefly in text form, details of which will be given to you at the end of the previous question. You will have five minutes to review the scenario before the question starts. You will then have 8 minutes to take part in a role play with an experienced actor.
This scenario focuses less on clinical knowledge, but deals more with consideration of the moral, ethical or legal issues related to patient care.
Communication assessment
Following the role play, you will be given 2 minutes to reflect on your communication skills displayed at this station. After the interview has finished the actor will give feedback to the panel about your communication and professionalism which will contribute to the score.
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 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 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 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 |
||||
Suitability and commitment |
/ 5 |
/ 5 |
2.0 |
20 |
Question 2 |
||||
Medical registrar suitability |
/ 5 |
/ 5 |
1.5 |
15 |
Question 3 |
||||
Ethical communication scenario |
/ 5 |
/ 5 |
2.0 |
20 |
Communication reflection mark |
/ 5 |
/ 5 |
1.0 |
10 |
Question 4 |
|
|||
Professionalism and governance |
/5 |
/5 |
1.5 |
15 |
Raw interview score |
/ 50 |
|||
Interview score (w weighting) |
/ 80 |
|||
Application score |
/ 40 |
0.5 |
/ 20 |
|
Total score |
/ 100 |