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 

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. 

 

From 2022 Palliative Medicine will be 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. 

 


Medical Care

Find out more about palliative 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 palliative medicine 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.

This speciality will be participating in round 2 this 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 2 Interview dates & posts

Region
NTN posts
LAT posts*
Evidence upload date(s) Interview date(s)
East Midlands
0 - 1
N/A
19/08/2022 - 26/08/2022

12/10/2022- 13/10/2022

East of England
9 - 11
N/A
London
1 - 10
N/A
North East
TBC
N/A
North West 
0
N/A
South West
Peninsula
TBC
N/A
Severn
0 - 1
N/A
Thames Valley
0
N/A
Wessex
TBC
N/A
West Midlands
0 - 1
N/A
Yorkshire & Humber
0 - 3
N/A
Scotland**
TBC
TBC
Wales
4 - 5
TBC
Northern Ireland
0 -1 0 - 1

*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 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 5-10 minutes in length. You will be marked on these questions and your communication skills, giving five scored 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 40-45 minutes.

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.

If your 12 interview scores contain one or two marks of 2/5 (and the rest 3/5 or above), and you receive a total raw interview score of 36 or above, 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 three 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 falls under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable .

Total score calculation

After interview, a weighting is applied to the scores in each area, and a score derived from your application form is then added to give your 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.

Application score calculation

The initial application score is used to shortlist applications. At interview this specialty reviews achievements from the application form against the re-scoring matrix in the document below to calculate the score which will contribute to the total score.

Whilst some achievements do not directly contribute to the re-scoring matrix, they will form part of the interviewers’ assessment in station 1 when awarding their score. In particular, quality improvement and teaching normally form a major part of the questioning in this station and as such are likely to significantly influence interviewers’ scoring; which will affect both the total score and determination of appointability. Thus these two domains should not be overlooked or considered any less important in any application. 

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.

Interview content

The interview will consist of four question areas which will be between 5-8 minutes each in length. You will be marked on these four questions, with a fifth mark given for your communication and reflection skills shown in the ethical scenario.

Including time for questioning and changeover between questions, the interview will be approximately 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

Suitability and commitment

/ 5

/ 5

2.5

25

Question 2

Medical registrar suitability 

/ 5

/ 5

1

10

Question 3

Professionalism & Governance

/ 5

/ 5

2.5

25

Question 4

 

Ethical communication scenario

/ 5

/ 5

1.8

18

Communication reflection mark

/ 5

/ 5

1.2

12

Raw interview score

/ 50

Interview score (w weighting)

/ 90

 Application score

/ 58

0.35

/ 20.3

 Total score

/ 110.3