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 attachements 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.

Specialty structure

Acute internal medicine was formally recognised as a specialty in 2009, having previously been a subspecialty of general internal medicine.

It can be entered from core medical training or acute care common stem training; entry at ST3-level requires full membership of the royal college of physicians, MRCP(UK).

The indicative training time is 4 years for AIM or 5 years for AIM plus GIM dual speciality training. If stroke or critical care CCTs are aded the training will typically be 6 years or longer.


Further information

Queries regarding the progress of a submitted application should be directed to the region managing your application.

In round 1, this specialty uses the single cascadable application (SCA) recruitment model. Applications are managed by the region to which they have been devolved. Once long and shortlisting are complete, applications may be cascaded to an alternative regional preference. In this case, the inviting region will have taken over the management of your application and you will be informed of this via email.

For regions which are part of cluster, you will need to contact the lead region with queries relating to application progress. The lead region of a cluster can be seen on the 'interview dates & posts' tab above.

For contact details please refer to the region contacts page.

General / application queries

For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Specialty Recruitment Office at the JRCPTB via email at st3recruitment@jrcptb.org.uk.

Eligibility

This specialty uses the standard ST3 eligibility criteria, and does not accept candidates from any alternative training routes.

Please visit the am I eligible? section of this website for further information.

Cascadable application model

This specialty uses the cascadable application model. If you apply to this specialty you will be required to give (up to) four preferences of regions on your application form, ranked in order of preference.

Once your application is confirmed as eligible, in shortlisting, you will be allocated to a region for interview based on the score awarded to your application and subsequent ranking, your regional preferences and the interview capacity available at each region.

So your application will be allocated to your first-choice preference region if possible; if the region has reached capacity with higher-scoring applicants, it will instead be cascaded to your second-choice; if that is also full, it will then be cascaded to your third-choice; and so on.

Most applicants are allocated to their first choice with a few cascaded to a lower preference. In a small number of cases, usually where an applicant only preferences one or two regions, an applicant will not be shortlisted. Information on the outcome of shortlisting from previous years is available in the document library.

Regional clusters

There will be some instances of neighbouring regions joining together for recruitment purposes, forming amalgamated regional ‘clusters’. A candidate applying to any such cluster can consider all posts available across all constituent regions within the cluster.

Clearing

As the main round draws to a close this specialty can implement a period of national clearing, should any vacancies remain. Further information can be found in the clearing section.

Round 2

If participating in round 2, this specialty will use the single centre recruitment model, whereby the specialty will nominate a particular region to act as lead for the round and host all interviews with applications made nationally; the lead region will be confirmed in the lead up to the start of the round.

It is possible that there could be changes between now and the interview period. Please bear this in mind when reviewing the information below, although in most cases it is not expected this will change, or any changes will be minimal.  You are advised to check back in closer to the time of interview. The date at the foot of this page shows when the page was last updated.

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 falls 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.


Establishing appointability

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  o f 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 .

Appointability subject to panel decision

In the event that your 12 interview scores contain  one or two 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 weighting

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

These scores are then combined to give your total score which is determing 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, 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.

page updated 17 February 2017

As part of the process of applying to ST3, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in JRCPTB-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.

Provisional post numbers

Specialty 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.

It is the intention that initial post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed.  Numbers will be updated as and when notifications are received from each region and will be checked later in the round when programme preferences are open for selection.

Numbers subject to change

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

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. On average post numbers rise between 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 & post numbers

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

West Midlands 
Thursday 5 October

HE East of England tbc n/a

London and South East

tbc

 n/a
 n/a
HE North East tbc n/a
HE North West

Mersey

tbc

n/a

North Western

tbc

n/a
HE South West

Peninsula

tbc

n/a

Severn

tbc

n/a
HE Thames Valley tbc n/a
HE Wessex tbc n/a
HE West Midlands tbc n/a
HE Yorkshire & Humber tbc n/a
Scotland** tbc tbc
Wales tbc tbc

Round 1 Interview dates & post numbers

Region NTN posts LAT posts*Interview date(s)
HE London and South East 

(London) 

5

n/a

Friday 24 March

(Kent, Surrey, Sussex) 

11

n/a
HE East of England 18 n/a West Midlands
Wednesday 5 April
HE West Midlands (lead) 6 n/a
HE East Midlands 5 n/a
HE North East (lead) 6 n/a

North East

Wednesday 12 April

HE North West 

(Mersey) 

5

n/a

(North Western) 

5

n/a
HE Yorkshire & Humber 20 n/a
HE South West

(Peninsula)

2

n/a Thames Valley
Thursday 20 April

(Severn)

4

n/a
HE Wessex  9 n/a
HE Thames Valley (lead) 5 n/a
Wales 4 0 Thursday 23 March
Scotland**  19 0

Friday 31 March

*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 deaneries 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 JRCPTB-coordinated process.

Please note that whilst we endeavour to keep the ST3 recruitment website up to date, the SMT website will always be the more accurate one where they differ.